机器人联合股骨头干互动复位治疗难复性股骨颈骨折
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安徽医科大学第一附属医院骨科

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中图分类号:

R683.42

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国家重点研发计划资助项目


Robot combined with femoral shaft interactive reduction in the treatment of irreducible femoral neck fracture
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Affiliation:

Dept of orthopaedics,The First Hospital of Anhui Medical University

Fund Project:

Supported by national Key RESEARCH and development Program of China

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    摘要:

    摘要:[目的] 介绍机器人联合股骨头干互动闭合复位治疗难复性股骨颈骨折的手术技术和临床结果。[方法] 我科2018年1月-2020年12月使用机器人联合股骨头干互动闭合复位技术治疗难复位性股骨颈骨折15例。首先机器人辅助下于置入股骨颈3根导针、头部1根导针,然后透视下互动调整股骨头的摇杆导针和骨折远端,得到骨折满意复位时使3根导针穿过骨折线固定骨折,最后空心钉固定。[结果] 平均手术时间59.60 min,患者和术者平均透视分别20.87和6.27次,平均出血10.40 mL,导针平均置入6.0次。髋关节X线片上任意2根螺钉夹角平均:正位2.35°,侧位2.53°,每根螺钉与股骨颈轴线夹角平均:正位3.85°,侧位3.87°。其中1例患者内固定失效,其余无感染、内固定失效及股骨头坏死等并发症,平均愈合时间6.29个月。术后1年髋关节Harris评分平均88.67分,优良率93.33%。[结论] 机器人联合股骨头干互动闭合复位技术成功治疗难复性股骨颈骨折,具有放射损害低、骨折复位质量高、内固定精准度高及髋关节功能好等优点。

    Abstract:

    Abstract: [Objective] To introduce the surgical technique and clinical results of robot combined with interactive closed reduction of femoral head and shaft in the treatment of irreducible femoral neck fracture.[Methods] From January 2018 to December 2020, our department used robot combined with interactive closed reduction of femoral head and stem to treat 15 cases of refractory femoral neck fractures. Firstly, three guide pins in the femoral neck and one guide pin in the head are inserted with the assistance of robot, and then the rocker guide pin and the distal end of the fracture are interactively adjusted under fluoroscopy. When the fracture is satisfactorily reduced, the three guide pins are fixed through the fracture line, and finally the hollow screw is fixed. [Results] The average operation time was 59.60 min, the average fluoroscopy of patients and operators were 20.87 and 6.27 times, the average bleeding was 10.40 ml, and the average placement of guide needle was 6.0 times. The average included angle of any two screws on the X-ray film of hip joint: positive position 2.35 °, lateral position 2.53 °, the average included angle between each screw and the axis of femoral neck: positive position 3.85 °, lateral position 3.87 °. One patient had internal fixation failure, and the rest had no complications such as infection, internal fixation failure and femoral head necrosis. The average healing time was 6.29 months. One year after operation, the average Harris score of hip joint was 88.67, and the excellent and good rate was 93.33%. [Conclusion] Robot combined with femoral head and stem interactive closed reduction technology has successfully treated refractory femoral neck fractures. It has many advantages including low radiation damage, high fracture reduction quality, high internal fixation accuracy and good hip function.

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  • 收稿日期:2022-01-03
  • 最后修改日期:2022-03-11
  • 录用日期:2022-06-01
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