骨科天玑机器人辅助下闭合复位空心钉固定治疗股骨颈骨折的疗效分析

Analysis of Closed Reduction Hollow Nail Fixation with the Aid of Orthopedic Tianji Robot in the Treatment of Femoral Neck Fracture

目的探讨骨科天玑机器人辅助下闭合复位空心钉固定治疗股骨颈骨折的疗效。方法选取2019年1月—2022年1月南京市江宁医院收治的行闭合复位空心钉固定治疗的62例股骨颈骨折患者资料进行回顾性分析,按置钉方式差异分为对照组(n=32)和观察组(n=30例),予以对照组传统徒手置钉,观察组则基于骨科天玑机器人辅助下置钉,比较两组围术期指标(手术时间、术中出血量、术中透视次数及导针钻入次数)、空心钉平行度及偏离度、康复效果(以Harris髋关节功能评分、骨折愈合时间及并发症综合评估)。结果观察组手术时间为(57.42±15.29)min,较对照组的(73.25±18.42)min更短,观察组术中出血量、术中透视次数、导针钻入次数分别为(12.05±4.38)mL、(13.92±2.12)次、(3.87±0.96)次,较对照组的(24.36±8.27)mL、(22.37±4.86)次、(5.02±1.27)次均更少,差异有统计学意义(t=3.669、7.252、8.770、4.002,P<0.05)。观察组正、侧位空心钉平行度以及空心钉轴线与股骨颈颈干偏离角均小于对照组,差异有统计学意义(P<0.05)。观察组HHS评分高于对照组,差异有统计学意义(P<0.05),而两组骨折愈合时间、并发症发生率比较,差异无统计学意义(P>0.05)。结论股骨颈骨折应用骨科天玑机器人辅助下闭合复位空心钉固定治疗可获良好手术效果,缩短手术时间,减少术中出血量、透视次数及导针钻入次数,定位精准性有所提升,且有利于术后髋关节功能恢复。

Objective To investigate the effect of closed reduction hollow nail fixation with the aid of orthopedic Tianji robot in the treatment of femoral neck fracture.Methods The data of 62 patients with neck of femur fracture who were treated by closed reduction and cannulated nail fixation in Nanjing Jiangning Hospital from January 2019 to January 2022 were retrospectively analyzed.According to the difference of nail placement methods,they were divided into the control group(n=32)and the observation group(n=30).The control group was given the traditional manual nail placement.The observation group was based on the orthopedic Tianji robot assisted nail placement.Compared the perioperative indicators(surgical time,intraoperative bleeding volume,intraoperative fluoroscopy frequency,and guide needle penetration frequency),the parallelism and deviation of hollow screws,and the rehabilitation effect between two groups(evaluated comprehensively based on Harris hip joint function score,fracture healing time,and complications).Results The operating time of the observation group was(57.42±15.29)minutes,which was shorter than the control group's(73.25±18.42)minutes,the intraoperative bleeding volume,intraoperative fluoroscopy frequency,and needle penetration frequency of observation group were(12.05±4.38)mL,(13.92±2.12)times,and(3.87±0.96)times,respectively,compared with the control group's(24.36±8.27)mL,(22.37±4.86)times,and(5.02±1.27)times,the difference was statistically significant(t=3.669,7.252,8.770,4.002,P<0.05).The parallelism of the anterior and lateral cannulated nails and the deviation angle between the axis of the cannulated nails and the neck shaft of the neck of femur in the observation group were smaller than those in the control group,and the difference was statistically significant(P<0.05).The HHS score of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).However,there was no statistically significant difference in fracture healing time and complication incidence between the two groups(P>0.05).Conclusion The application of closed reduction hollow nail fixation with the aid of orthopedic Tianji robot in the treatment of femoral neck fracture can achieve good surgical effect,shorten the operation time,reduce intraoperative blood loss,fluoroscopy times and guide needle drilling times,improve the positioning accuracy,and contribute to the postoperative hip functional recovery.