应用TiRobot机器人辅助经皮空心螺钉内固定治疗髋臼前柱骨折的疗效

Effect of TiRobot system assisted percutaneous hollow screw internal fixation for the treatment of acetabular anterior column fracture

目的 探讨应用TiRobot机器人辅助经皮空心螺钉内固定治疗髋臼前柱骨折的疗效.方法 回顾分析2016年12月至2017年10月在济南市第三人民医院创伤骨科采用TiRobot机器人辅助经皮空心螺钉内固定治疗的9例髋臼前柱骨折患者的病历资料.受伤至手术时间4~10h.观察并记录术中X线透视时间及次数、螺钉置入时间及位置、手术时间、切口长度、出血量、骨折愈合时间等.并采用Majeed评分标准评估术后功能.结果 9例患者共置入10枚髋臼前柱经皮空心螺钉.其中1例为双侧髋臼前柱骨折.其余8例为单侧髋臼前柱骨折.平均手术时间65min.平均透视次数12次.手术切口平均1.5cm.平均术中出血量25ml.置入的螺钉位置均满意.无穿出骨皮质.伤口均获得Ⅰ期愈合.未出现医源性血管、神经及脏器损伤.术后随访5(3~6)个月.无骨折延迟愈合或畸形愈合.末次随访时.优7例.良2例.结论 应用TiRobot机器人辅助经皮空心螺钉内固定治疗髋臼前柱骨折的手术精确性高、安全性好.且具有手术时间短、微创、对患者及医务人员放射性损害小、术后功能康复早等优点.

Objective To investigate the curative effect of the surgical treatment of acetabular anterior column fracture by orthopedic surgery robot assisted percutaneous hollow screw internal fixation. Methods The clinical data of 9 patients with acetabular anterior column fracture were treated by TiRbot system assisted percutaneous hollow screw internal fixation in the Department of Traumatology. the Third People's Hospital of Jinan between December 2016 and October 2017. The time from injury to operation time was 4-10 hours. The time of X-ray perspective and the number of fluoroscopy. the time of screw insertion. the position of the screw. the time of operation and the length of the incision were recorded. The postoperative function was performed by Majeed score system. Results A total of 10 percutaneous hollow screws were inserted into the anterior pillar of the acetabular column in 9 patients. One patient had bilateral acetabularanterior column fractures and the remaining 8 patients had unilateral acetabular anterior column fractures. The average operation time was 65 min? the average X￣ray number was 12 times? the average length of incision was 1. 5 cm? and the average blood loss was 25 ml. All screws were inserted in the accurate site? and there was no screw penetrated through bone cortex. All wounds were primary healing. There was no iatrogenic injury on blood vessels? nerves and organs occurred. During the followed￣up of 3￣6 months (average 5 months)? delayed union or malunion was not observed. At the final followed￣up? 7 cases were excellent and 2 cases were good. Conclusion TiRobot system assisted percutaneous hollow screw internal fixation for the treatment of acetabular anterior column fracture is accurate and safe. It has the advantage of short operative time? small trauma? low radiation damage to patients and medical staff? and early postoperative rehabilitation.