双平面机器人导航辅助下空心钉内固定治疗股骨颈骨折

Treatment of Femoral Neck Fractures with Hollow Nail Internal Fixation Assisted by Biplane Robot Navigation

目的分析双平面机器人导航辅助下空心钉内固定治疗股骨颈骨折的临床疗效。方法回顾性分析选取自2017年5月-2020年5月采取空心钉内固定治疗股骨颈骨折的患者66例。按照是否采用双平面机器人导航辅助分为对照组和研究组,每组33例。对比两组患者的术中透视时间、术中透视次数、导针钻孔次数、置入时间、更换次数、出血量、骨折愈合时间、患肢功能评分、术后侧位X线片上任意两枚空心钉之间的角度、每一枚空心钉与股骨颈轴线之间的角度。结果研究组的术中透视时间(10.18±2.97)s短于对照组(36.82±7.54)s,术中透视次数(11.47±3.26)次、出血量(29.43±14.72)mL少于对照组(43.94±11.05)次、(50.23±17.11)mL,差异有统计学意义(t=18.884、16.190、5.294,P<0.05)。研究组导针钻孔次数(3.92±1.14)次、更换次数(0.42±0.63)次少于对照组(18.53±3.27)次、(1.09±0.74)次,置入时间(28.83±7.31)min短于对照组(43.88±7.94)min,差异有统计学意义(t=24.236、3.960、8.011,P<0.05)。对照组(6.35±2.84)月和研究组(5.81±2.55)月的骨折愈合时间对比,差异无统计学意义(t=0.813,P>0.05)。研究组Harris评分(83.29±2.36)分高于对照组(80.51±3.94)分,差异有统计学意义(t=3.477,P<0.05)。研究组任意两枚空心钉之间的夹角度数小于对照组,差异有统计学意义(P<0.05)。研究组每一枚空心钉与股骨颈轴线之间的夹角度数小于对照组,差异有统计学意义(P<0.05)。结论双平面机器人导航辅助下空心钉内固定治疗股骨颈骨折能提升手术的精确度,减少空心钉置入时间。

Objective To analyze the clinical effect of hollow nail internal fixation in the treatment of femoral neck fractures assisted by biplane robot navigation.Methods A retrospective analysis of 66 patients with femoral neck fractures treated with hollow nail internal fixation from May 2017 to May 2020 was selected.According to whether dual-plane robot navigation was used or not,they were divided into a control group and a study group,with 33 cases in each group.Compared the intraoperative fluoroscopy time,the number of intraoperative fluoroscopy,the number of guide pin drilling,the time of insertion,the number of replacements,the amount of bleeding,the healing time of the fracture,the function score of the affected limb,and any two of the postoperative lateral X-rays,the angle between the hollow nails,the angle between each hollow nail and the axis of the femoral neck.Results The intraoperative fluoroscopy time of the study group(10.18±2.97)s was shorter than that of the control group(36.82±7.54)s,the number of intraoperative fluoroscopy was(11.47±3.26)times,and the blood loss(29.43±14.72)mL was less than that of the control group(43.94±11.05)times,(50.23±17.11)mL,the difference was statistically significant(t=18.884,16.190,5.294;P﹤0.05).The number of guide pin drilling times(3.92±1.14)times and the number of replacement times(0.42±0.63)times in the study group were less than those in the control group(18.53±3.27)times,(1.09±0.74)times,and the insertion time(28.83±7.31)min was shorter than that of the control group(43.88±7.94)min,the difference was statistically significant(t=24.236,3.960,8.011,P<0.05).Compared the fracture healing time of the control group(6.35±2.84)months and the study group(5.81±2.55)months,the difference was not statistically significant(t=0.813,P>0.05).The Harris score(83.29±2.36)points of the study group was higher than that of the control group(80.51±3.94)points,the difference was statistically significant(t=3.477,P<0.05).The number of angles between any two hollow nails in the study group was less than in the control group,the difference was statistically significant(P<0.05).The number of angles between each hollow nail and the axis of the femoral neck in the study group was smaller than that in the control group,the difference was statistically significant(P<0.05).Conclusion The internal fixation of hollow nails for femoral neck fractures assisted by biplane robot navigation can improve the accuracy of the operation and reduce the time of hollow nail insertion.