论文部分内容阅读
目的:探讨TiRobot骨科手术机器人辅助下微创经皮通道螺钉固定治疗骨盆骨折的临床疗效。方法:回顾性分析2018年5月至2021年4月期间吉林大学第一医院创伤骨科收治的44例骨盆骨折患者资料。男30例,女14例;年龄为11~78岁,平均40.6岁。骨折Tile分型:C1型20例,C2型23例,C3型1例。受伤至手术时间为1~41 d,平均8.2 d。所有患者均采用TiRobot骨科手术机器人辅助下行经皮骨盆通道螺钉内固定术。记录患者的手术时间、术中累计透视时间、骨折复位质量、并发症发生情况及末次随访时骨盆功能恢复情况等。结果:本研究共置入通道螺钉96枚,患者术中累计透视时间为17~66 s,平均每枚螺钉透视时间为17.8 s;手术时间为50~355 min,平均179.7 min。根据Matta评分标准评定骨折复位质量:优36例,良5例,可3例,优良率为93.2%(41/44)。44例患者术后获6~42个月(平均20.4个月)随访,骨折愈合时间为2~6个月,平均3.3个月。末次随访时Majeed骨盆功能评分为51~100分,平均83.7分;优28例,良8例,可7例,差1例,优良率为81.8%(36/44)。随访期间无一例患者发生医源性血管神经损伤、切口感染及愈合不良、内固定物松动或骨折再移位等并发症。结论:TiRobot骨科手术机器人微创经皮通道螺钉固定治疗骨盆骨折疗效良好,具有精准、微创、安全等优势。“,”Objective:To investigate the clinical efficacy of TiRobot-assisted minimally invasive percutaneous screw fixation for pelvic fractures.Methods:The clinical data of 44 patients with pelvic fracture were retrospectively analyzed who had undergone TiRobot-assisted minimally invasive percutaneous screw fixation from May 2018 to April 2021 at Department of Orthopedic Traumatology, The First Hospital of Jilin University. There were 30 males and 14 females, aged from 11 to 78 years (average, 40.6 years). According to the Tile classification, there were 20 type C1 fractures, 23 type C2 fractures and one type C3 fracture. The time from injury to operation averaged 8.2 days (from 1 to 41 days). The minimally invasive percutaneous screw fixation was assisted by the orthopaedic TiRobot in all patients. Operation time, fluoroscopy time, reduction quality, complications and functional recovery at the final follow-up were recorded and analyzed.Results:A total of 96 screws were implanted in this cohort. The total fluoroscopy time ranged from 17 to 66 s, with an average of 17.8 s for each single screw. The operation time ranged from 50 to 355 min, averaging 179.7 min. According to the Matta criteria, the reduction quality was rated as excellent in 36 cases, as good in 5 and as fair in 3, yielding an excellent and good rate of 93.2%(41/44). All the 44 patients were followed up for 6 to 42 months (average, 20.4 months). The fracture healing time ranged from 2 to 6 months, averaging 3.3 months. The Majeed scores at the final follow-up ranged from 51 to 100 points (average, 83.7 points); there were 28 excellent, 8 good, 7 fair and one poor cases, giving an excellent to good rate of 81.8% (36/44). Follow-up found no such complications as iatrogenic neurovascular injury, incision infection, malunion, implant loosening or fracture re-displacement in all the 44 patients.Conclusion:TiRobot-assisted minimally invasive internal fixation can result in fine clinical efficacy for pelvic fractures, showing advantages of accuracy, minimal invasion and safety.