天玑骨科机器人辅助与传统切开复位内固定治疗跟骨骨折的临床对比研究

Clinical comparative study of Tianji orthopedic robot assisted surgery and traditional open reduction and internal fixation in the treatment of calcaneal fracture

目的 研究天玑Ⅱ代骨科机器人辅助下微创治疗跟骨骨折与传统经跗骨窦切开螺钉内固定的疗效差异。方法 选取2020年4月至2022年10月期间武汉科技大学附属普仁医院收治的20例跟骨骨折患者为研究对象,根据手术方式的不同分为两组:研究组8例,男7例,女1例,使用天玑Ⅱ代骨科机器人辅助微创治疗;对照组12例,男9例,女3例,使用传统经跗骨窦切开复位内固定治疗。分析比较两组患者住院时间、术前等待时间、手术时间、手术切口长度、术中透视次数、术中出血、术后3个月和6个月美国骨科协会足踝外科分会(AOFAS)评分及相关并发症发生率。结果 两组患者一般资料(年龄、性别、患侧、骨折分型)差异均无统计学意义(P>0.05)。研究组住院时间、术前等待时间、手术切口长度、术中透视次数、术中出血量均低于对照组[(9.500±3.423)d vs.(14.830±3.040)d、(4.750±2.964)d vs.(7.750±2.563)d、(3.250±0.463)cm vs.(7.667±1.435)cm、(4.250±1.282)次vs.(6.667±1.614)次、(14.380±7.289)mL vs.(51.670±19.460)mL],差异有统计学意义(P<0.05)。研究组手术时间较对照组长[(80.130±3.271)min vs.(69.250±3.729)min],差异有统计学意义(P<0.05)。研究组术后3个月AOFAS评分高于对照组[(77.130±3.441)分vs.(70.830±3.512)分],差异有统计学意义(P<0.05),而两组间骨折愈合时间及术后6个月AOFAS评分差异无统计学意义(P>0.05)。结论 天玑Ⅱ代骨科机器人辅助下微创治疗跟骨骨折相对传统经跗骨窦切开复位内固定治疗有着手术切口小、术中出血少、术中透视少的优势,能缩短患者的住院时间及术前等待时间,且能够使患者早期获得更好的功能康复。

Objective To investigate the difference of curative effect between traditional open reduction and internal fixation and minimally invasive surgery assisted by TianjiⅡgeneration orthopedic robot in the treatment of calcaneal fracture.Methods 20 patients with calcaneal fracture admitted to Puren Hospital Affiliated to Wuhan University of Science and Technology from April 2020 to October 2022 were selected.According to the different surgical methods,they were divided into two groups:the study group(8 cases,7 males and 1 female)was treated with TianjiⅡorthopedic robot assisted minimally invasive surgery,and the control group(12 cases,9 males and 3 females)was treated with traditional open reduction and internal fixation.The hospitalization time,preoperative waiting time,operation time,surgical incision length,fluoroscopy times during operation,intraoperative bleeding,American Orthopaedic Foot and Ankle Society(AOFAS)score at 3 and 6 months after operation and the incidence of related complications were analyzed and compared between the two groups.Results There was no significant difference in the general information(age,gender,affected side and fracture type)between the two groups(P>0.05).The hospitalization time,preoperative waiting time,surgical incision length,fluoroscopy times during operation and intraoperative bleeding in the study group were lower than those in the control group[(9.500±3.423)d vs.(14.83±3.040)d,(4.750±2.964)d vs.(7.750±2.563)d,(3.250±0.463)cm vs.(7.667±1.435)cm,(4.250±1.282)times vs.(6.667±1.614)times,(14.380±7.289)mL vs.(51.670±19.460)mL],and the differences were statistically significant(P<0.05).The operation time of the study group was longer than that of the control group[(80.130±3.271)min vs.(69.250±3.729)min],and the difference was statistically significant(P<0.05).The AOFAS score of the study group was higher than that of the control group at 3 months after operation[(77.130±3.441)min vs.(70.830±3.512)min],and the difference was statistically significant(P<0.05).The fracture healing time and the AOFAS score at 6 months after operation of the two groups were not statistically significant(P>0.05).Conclusion Compared with tradition al open surgery,minimally invasive surgery assisted by TianjiⅡgeneration orthopedic robot for calcaneal fracture has the advantages of smaller incision,less intraoperative bleeding and less intraoperative fluoroscopy,which can shorten the length of hospital stay and the time from injury to surgery,and enable patients to obtain better functional rehabilitation in the early stage.