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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:

33

期数:

2016年12

页码:

1085-1087

栏目:

临床研究

出版日期:

2016-12-05

文章信息/Info

Title:

Application value of robot navigation and positioning system in the cannulated screw internal fixation for femoral neck fracture

作者:

葛邦新; 段军富; 王　博; 郑成胜; 张小冰; 李　扬; 李云靖; 赵志彪; 付军振

（鹤壁市人民医院骨一科，河南　鹤壁　458030）

Author(s):

GE Bang-xin; DUAN Jun-fu; WANG Bo; ZHENG Cheng-sheng; ZHANG Xiao-bing; LI Yang; LI Yun-jing; ZHAO Zhi-biao; FU Jun-zhen

(Department of Osteology,the People′s Hospital of Hebi City,Hebi 458030,Henan Province,China)

关键词:

骨科机器人导航定位系统; 空心螺钉内固定术; 股骨颈骨折

Keywords:

orthopaedic robot navigation and positioning system; cannulated screw internal fixation; femoral neck fracture

分类号:

R683.42

DOI:

10.7683/xxyxyxb.2016.12.018

文献标志码:

A

摘要:

目的　探讨骨科机器人导航定位系统在股骨颈骨折（FNF）空心螺钉内固定术中的应用价值。方法　选择2014年10月至2015年11月鹤壁市人民医院收治的FNF患者38例，其中在骨科机器人导航定位系统辅助下行空心螺钉内固定术13例（机器人手术组），行传统空心螺钉内固定术25例（传统手术组），比较2组患者治疗效果。结果　与传统手术组比较，机器人手术组患者C臂透视时间和手术时间短（P<0.05），术中C臂投照次数少（P<0.05），一次性置钉准确率高（P<0.05）。2组患者术中出血量及住院时间比较差异均无统计学意义（P>0.05）。机器人手术组和传统手术组患者平均骨折愈合时间分别为（4.3±0.4）、（4.4±0.5）个月，2组患者骨折愈合时间比较差异无统计学意义（P>0.05）。机器人手术组患者无螺钉松动、退钉、骨折移位等，传统手术组患者术后1周因心血管并发症死亡1例，因术后内固定物松动致固定失效行关节置换1例，轻度髋内翻6例，螺钉松动、不同程度退钉3例。术后6个月，机器人手术组和传统手术组患者髋关节Harris评分分别为94.5±5.5和89.0±10.5，2组患者髋关节Harris评分比较差异无统计学意义（P>0.05）。机器人手术组和传统手术组患者治疗优良率分别为84.6%（11/13）和84.0%（21/25），2组患者治疗优良率比较差异无统计学意义（P>0.05）。结论　骨科机器人导航定位系统辅助下FNF空心螺钉内固定术定位精准，一次性置钉准确率高，手术时间短，术中辐射少，固定牢固。

Abstract:

Objective　To explore the application value of robot navigation and positioning system in the cannulated screw internal fixation for femoral neck fracture(FNF).Methods　Among the thirty-eight patients with FNF who were selected from October 2014 to November 2015 in the People′s Hospital of Hebi City,thirteen patients were performed with the cannulated screw internal fixation under the assistance of robot navigation and positioning system(robot surgery group),twenty-five patients were performed with the traditionary cannulated screw internal fixation(traditional surgery group).The effect was compared between the two groups.Results　Compared with traditional surgery group,the X-ray irradiation time by C-arm and operation time were shorter(P<0.05),the irradiation times of C-arm was less during the operation(P<0.05),and the success rate of the first screw implantation was higher in robot surgery group(P<0.05).There was no significant difference in the intraoperative bleeding volume and hospitalization time between the two groups(P>0.05).The average fracture healing time in robot surgery group and traditional surgery group was(4.3±0.4)and(4.4±0.5)months respectively,there was no significant difference in the fracture healing time between the two groups(P>0.05).There was no screw loosening,nail withdrawal and fracture displacement in robotic surgery group.In traditional surgery group,one patient died because of cardiovascular complications,one patient was performed with joint replacement because of internal fixation loosening,six patients had mild coxa vara,three patients had screw loosening and certain nail withdrawal.Six months after operation,the Harris score of hip joint in robot surgery group and traditional surgery group was 94.5±5.5 and 89.0±10.5 respectively,there was no significant difference in Harris score between the two groups(P>0.05).The fineness rate in robot surgery group and traditional surgery group was 84.6%(11/13)and 84%(21/25)respectively,there was no significant difference in the fineness rate between the two groups(P>0.05).Conclusion　The robot navigation and positioning system assisted cannulated screw internal fixation for FNF has accurate position fixing,high success rate of the first screw implantation,short operation time,less radiation and solid internal fixation.

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更新日期/Last Update: 2016-12-05