中国组织工程研究

中国组织工程研究 ›› 2019, Vol. 23 ›› Issue (24): 3792-3797.doi: 10.3969/j.issn.2095-4344.1290

• 骨科植入物 orthopedic implant • 上一篇    下一篇

骨科手术机器人导航辅助与传统髓内钉内固定治疗股骨转子间骨折的比较

谭  哲1，2，李开南2，兰  海1，2
  

  1. 1遵义医科大学，贵州省遵义市  563000；2成都大学附属医院骨科，四川省成都市   610081
  • 出版日期:2019-08-28 发布日期:2019-08-28
  • 通讯作者: 兰海，博士，主任医师，硕士生导师，主任，成都大学附属医院骨科，四川省成都市 610081
  • 作者简介:谭哲，男，1989年生，四川省雅安市人，汉族，遵义医科大学在读硕士，医师，主要从事骨组织工程和数字化骨科方面的研究。
  • 基金资助:
    国家重点研发计划课题(2016YFC0105806)，项目参与人：李开南，兰海

Comparison of the efficacy of intramedullary nail fixation assisted by orthopedic robot navigation and traditional surgery for intertrochanteric fractures  

Tan Zhe1, 2, Li Kainan2, Lan Hai1, 2
  

  1. 1Zunyi Medical University, Zunyi 563000, Guizhou Province, China; 2Department of Orthopedics, Affiliated Hospital of Chengdu University, Chengdu 610081, Sichuan Province, China
  • Online:2019-08-28 Published:2019-08-28
  • Contact: Lan Hai, MD, Chief physician, Master’s supervisor, Zunyi Medical University, Zunyi 563000, Guizhou Province, China; Department of Orthopedics, Affiliated Hospital of Chengdu University, Chengdu 610081, Sichuan Province, China
  • About author:Tan Zhe, Master candidate, Physician, Zunyi Medical University, Zunyi 563000, Guizhou Province, China; Department of Orthopedics, Affiliated Hospital of Chengdu University, Chengdu 610081, Sichuan Province, China
  • Supported by:
    the National Key Research and Development Plan, No. 2016YFC0105806 (to LKN and LH)

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摘要：

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文题释义：
骨科手术机器人导航：为辅助进行骨科手术的一种导航辅助型外科手术机器人，手术医师可规划手术器械的空间定位，光学跟踪系统行实时空间位置监控，通过骨科手术机器人机械臂的运动使手术器械置入相应的解剖部位进行手术。
股骨转子间骨折：股骨颈基底至小转子水平以上部位所发生的骨折。
 
摘要
背景：利用骨科手术机器人导航辅助进行股骨转子间骨折髓内钉固定是一种新的手术方式，其与传统髓内钉内固定疗效比较的研究较少。
目的：通过对比骨科手术机器人导航辅助下与传统髓内钉内固定治疗股骨转子间骨折的疗效，分析运用骨科手术机器人导航辅助下髓内钉内固定治疗股骨转子间骨折的优劣势。
方法：收集成都大学附属医院骨科自2015年4月至2017年12月收治的股骨转子间骨折患者59例，根据手术方法分为2组，其中骨科机器人组28例经骨科手术机器人导航下行髓内钉内固定，传统手术组31例行传统髓内钉内固定。所有患者均签署手术知情同意书，且手术方案已获得成都大学附属医院伦理委员会等相关科室批准。记录手术时间、术中透视次数、术中髓腔导针穿刺次数、术中出血量并进行组间对比；术后1年观察骨折愈合情况及患侧髋关节功能。
结果与结论：①与传统手术组比较，机器人手术组患者手术时间短，术中透视次数少，导针穿刺次数少，手术出血量少，髓腔导针穿刺一次性成功率高(均P < 0.05)；②术后1年，2组患者均骨折愈合，未出现内固定物失效及骨折移位，骨科机器人手术组患者髋关节Harris评分高于传统手术组(P < 0.05)，2组患者患侧髋关节功能优良率比较差异无显著性意义(P > 0.05)；③结果表明，骨科手术机器人导航髓内钉内固定治疗股骨转子间骨折手术时间较短、创伤较小、医患双方术中受辐射较少，是股骨转子间骨折髓内钉内固定较为理想的方法。

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程
ORCID: 0000-0002-3385-5131(谭哲)

关键词: 骨科手术机器人, 导航, 股骨转子间骨折, 髓内钉, 内固定, 髋关节Harris评分, 精准治疗

Abstract:

BACKGROUND: Intramedullary nail fixation for intertrochanteric fractures assisted by orthopedic robot navigation is a new surgical method, and there are few studies comparing with traditional intramedullary nailing.
OBJECTIVE: To compare the efficacy of intramedullary nail fixation for intertrochanteric fractures assisted by orthopedic robot navigation and traditional surgery, and to analyze the advantages and disadvantages of intramedullary nail fixation for femoral intertrochanteric fractures assisted by orthopedic robot navigation.
METHODS: From April 2015 to December 2017, 59 patients with intertrochanteric fracture were collected from Department of Orthopedics, Affiliated Hospital of Chengdu University. According to the method of operation, there were two groups. Among them, 28 cases underwent intramedullary nail fixation assisted by orthopedic robot navigation (orthopedic robot surgery group), and 31 cases underwent traditional intramedullary nail fixation (traditional surgery group). All patients signed informed consent. The protocol was approved by the Ethics Committee of Affiliated Hospital of Chengdu University. The operation time, the times of intraoperative fluoroscopy, the frequency of guide pin inserted into femoral marrow cavity, and the amount of intraoperative bleeding were recorded and compared between groups. One year after operation, fracture healing and hip function were observed.
RESULTS AND CONCLUSION: (1) Compared with the traditional surgery group, the operation time was shorter; the times of intraoperative fluoroscopy was fewer; the frequency of guide pin inserted into femoral marrow cavity was lower; the amount of surgical bleeding was less; and the one-time success rate of the guide pin inserted into femoral marrow cavity was higher in the orthopedic robot surgery group (all P < 0.05). (2) One year after surgery, fracture healing was observed in both groups, and no internal fixator failure or fracture displacement occurred. The Harris score of hip joint in the orthopedic robot surgery group was higher than that in the traditional surgery group (P < 0.05). There was no significant difference in excellent and good rate between the two groups (P > 0.05). (3) Intramedullary nail fixation for intertrochanteric fractures assisted by orthopedic robot navigation is a better ideal method with short operation time, less trauma, and less radiation during operation.

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