摘要
[目的]介绍TiRobot机器人辅助经皮空心螺钉内固定治疗骨盆骨折骶髂关节骨折脱位的手术技术与初步临床结果。[方法]2019年1月~2020年1月,采用TiRobot机器人辅助经皮空心螺钉内固定治疗的骨盆骨折骶髂关节骨折脱位13例。术前影像明确骨折类型,进行手术设计。将机器人机械臂移动并固定至手术床旁。将示踪器固定于健侧髂前上棘骨质中,透视获取机器人定位标记点,在主控系统规划软件上进行手术螺钉路径规划。于入钉点行2 cm小切口,将机械臂所持套筒尖端抵至入钉点骨皮质,在主控工作站确认入钉点和虚拟探针方向是否符合规划,并进行微调,确认路径精准后,内钻入导针,沿导针拧入空心螺钉。[结果]手术共置入20枚螺钉,未出现医源性血管、神经及脏器损伤。置入的螺钉位置优良率100%。[结论]TiRobot机器人适用于辅助骨盆骨折骶髋关节骨折脱位,具有精确性高、安全性好的优点。
[Objective]To introduce the surgical technique and primary clinical outcomes of TiRobot assisted percutaneous screw fixation of iliosacral dislocation and fractures.[Methods]From January 2019 to January 2020,a total of 13 patients underwent TiRobot assisted percutaneous screw fixation for iliosacral dislocation and fractures.After a thorough preoperative imaging examination,the operative plane was made.As the mechanic arm of the Robot was close to bedside,a mark was placed into anterior superior iliac on the health side.The position messages of the mark were obtained by fluoroscopy and input into the main control processor to determine the inserting point and plan direction of the pin trace.After that a small incision 2 cm in length was made and a guider held by the mechanic arm was put on cortical bone of inserting point,to confirm the inserting point and pin trace again on the main control processor with readjustment.The guider pins were inserted,followed by cannulated screws to fix the iliosacral dislocation and fracture.[Results]A total of 20 screws were placed percutaneously,with no iatrogenic injuries to blood vessels,nerves and internal organs in anyone of them.The accuracy of screw placement was 100%.[Conclusion]The TiRobot assisted percutaneous screw has advantage of high accuracy and safety for fixation of iliosacral dislocation and fractures.
作者
聂涛
曾昭勋
黄胜
于小龙
孔令东
戴闽
NIE Tao;ZENG Zhao-xun;HUANG Sheng;YU Xiao-long;KONG Ling-dong;DAI Min(Department of Orthopaedics,The First Affiliated Hospital,Nan-chang Medical University,Nanchang330019,China)
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2020年第20期1897-1900,共4页
Orthopedic Journal of China
关键词
骶髋骨折脱位
机器人辅助技术
内固定
经皮螺钉
iliosacral dislocation and fractures
robot assisted technique
internal fixation
percutaneous screw