机器人辅助经皮掌侧入路全螺纹空心钉治疗新鲜稳定舟骨骨折

Treatment of fresh and stable scaphoid fractures by percutaneous hollow screw through volar approachwith Ti-Robot assistance

目的探讨骨科机器人系统辅助经皮掌侧入路全螺纹空心钉治疗新鲜稳定舟骨骨折的优势与不足。方法回顾分析自2018年1月至2019年10月于四川省人民医院收治的行骨科机器人系统辅助经皮掌侧入路全螺纹空心钉治疗的新鲜稳定舟骨骨折12例患者的病历资料。其中男10例,女2例;年龄20~50岁,平均30岁。记录手术时间,收集术中规划以及影像学资料,术中透视次数,术后复查X线片以及CT判断手术精准度,术后随访骨折愈合时间以及腕关节Mayo评分。结果12例患者手术时间平均45 min(包含患者体位的摆放以及机器人设备连接准备)。术中透视平均次数为8次,最少为6次,最多为12次。术中规划路线与透视结果以及术后CT均证实空心钉位于舟骨中轴。骨折平均愈合时间为10周。Mayo腕关节功能评分平均94分,优11例,良1例。结论机器人辅助经皮掌侧入路全螺纹空心钉治疗新鲜稳定舟骨骨折是一种操作简便.安全,可靠的治疗方法。该方法能够有效缩短手术时间,减少患者以及手术医生的辐射暴露。

Objective To explore the advantages and disadvantages of the treatment of fresh and stable scaphoid fractures with the assistant of orthopedic Ti-Robot system.Methods The medical records of 12 patients with fresh and stable scaphoid fractures treated by percutaneous volar hollow screw assisted by Ti-Robot system in Sichuan Provincial People's Hospital from January 2018 to October 2019 were retrospectively analyzed.There were 10 males and 2 females with an average age of 30 years(range,20 to 50 years).The operation time was recorded.The intraoperative planning and imaging data,intraoperative fluoroscopy times,postoperative X-ray and CT were reviewed to determine the accuracy of operation.The fracture healing time and Mayo wrist score were followed up.Results The average operation time of 12 patients was 45 minules(including the placement of patients’body position and preparation of robot equipment connection).The average times of intraoperative fluoroscopy were 8,6 times at least and 12 times at most.The results of intraoperative planning,fluoroscopy and postoperative CT confirmed that the hollow screw was located in the scaphoid axis.The average healing time was 10 weeks.The mean score of Mayo wrist function was 94,excellent in 11 cases and good in 1 case.Conclusion It is a simple,safe and reliable method to treat fresh and stables caphoid fractures by Ti-Robot assisted percutaneous hollow screw.This method can effectively shorten the operation time and reduce the radiation exposure of patients and surgeons.