机器人导航下顺行通道经皮螺钉内固定治疗髋臼前柱骨折
Treatment of Acetabular Anterior Column Fractures With Antegrade Percutaneous Screw Fixation Under Robot Navigation
文祖洲 1叶赟 1吴西智 1周华 1罗昂 1陈洪强 1赵奎2
作者信息
- 1. 贵阳市第四人民医院骨科,贵阳 550002
- 2. 贵州医科大学临床医学院,贵阳 550004
- 折叠
摘要
目的 探讨机器人导航下顺行通道经皮螺钉内固定治疗髋臼前柱骨折的临床疗效.方法 2021 年 4 月～2023 年1 月我科对7 例髋臼前柱骨折,利用骨盆"双反"牵引床牵引复位,骨科机器人辅助设计规划螺钉进针点与方向,顺行通道空心螺钉内固定.结果 手术时间60～95 min,平均78 min;术中出血量5～20 ml,平均8.6 ml;透视次数7～11 次,平均8.7 次;3 例导针未调整,4 例导针调整 1～2 次(调整 1 次 2 例,调整 2 次 2 例);实际路径与规划偏离 0.65～1.50 mm,(0.98±0.30)mm;螺钉位置优良率100%.术后48h行X线和CT检查,根据Matta复位标准:解剖复位6 例,满意复位1 例.7 例随访时间6～28 个月,平均15 个月.末次随访时髋关节Harris评分85～96 分,平均91.6 分;疼痛视觉模拟评分 0 分;均无感染、内置物松动、神经功能障碍等并发症.结论 机器人导航下顺行通道经皮螺钉内固定治疗髋臼前柱骨折安全高效,效果满意.
Abstract
Objective To investigate the clinical effect of anterograde percutaneous screw fixation under robot navigation in the treatment of acetabular anterior column fractures.Methods A retrospective analysis was made on 7 cases of anterior acetabular column fractures from April 2021 to January 2023.The traction reduction was conducted by using pelvic"double reverse"traction table,the orthopedic robot-assisted design was carried out to plan the screw entry point and direction,and the antegrade channel cannulated screw was used for internal fixation.Results The operation time was 60-95 min(mean,78 min).The intraoperative blood loss was 5-20 ml(mean,8.6 ml).The number of fluoroscopy was7-11(mean,8.7).The guide needle was unadjusted in 3 cases and adjusted for 1-2 times in 4 cases(once in 2 cases and twice in 2 cases).The actual path deviated from the planned by 0.65-1.50 mm(mean,0.98±0.30 mm).The excellent and good rate of screw position was 100%.X-ray and CT examinations were performed at 48 h after the operation.According to the Matta reduction standard,anatomical reduction was achieved in 6 cases and satisfactory reduction in 1 case.All the 7 cases were followed up for 6-28 months(mean,15 months).At the last follow-up,the Harris score of the hip joint was85-96 points(mean,91.6 points)and the pain of visual analogue scale(VAS)was0.There were no complications such as infection,loosening of internal fixation,or neurological dysfunction.Conclusion Anterograde percutaneous screw fixation under robot navigation in the treatment of acetabular anterior column fractures is safe,effective,and satisfactory.
关键词
机器人/顺行通道/经皮螺钉/髋臼骨折Key words
Robot/Antegrade passage/Percutaneous screw/Acetabular fracture引用本文复制引用
出版年
2024
NETL
NSTL
维普
万方数据