智能机器人辅助骨折复位系统在Tile C1-2型骨盆骨折治疗中的应用

Application of the intelligent robot-assisted reduction system in minimally invasive treatment of Tile-type C pelvic fractures

目的:探讨智能机器人辅助骨折复位系统(RAFR)在Tile C1-2型骨盆骨折治疗中的应用效果。方法:回顾性分析2022年6月至2023年11月期间佛山市中医院创伤骨科收治的15例Tile C1-2型骨盆骨折患者资料。男7例,女8例;年龄(51.6±22.1)岁;体重指数为(22.35±2.14)kg/m 2;骨折Tile分型:C1型9例,C2型6例。受伤至手术时间为(11.3±3.9)d。所有患者均在RAFR辅助下完成微创闭合复位。骨盆前环采用耻骨支经皮空心螺钉固定,骨盆后环采用骶髂关节经皮空心螺钉固定。必要时使用外固定支架、骨盆前环内支架固定技术增强骨盆环的稳定性。记录患者的术中透视次数、透视时间、复位时间、手术时间、术中出血量、骨折复位质量、随访时间、骨折愈合时间、末次随访时骨盆功能恢复情况及并发症发生情况等。 结果:15例患者的术中透视次数为31(20,55)次,透视时间为25.8(18.0,33.0)s,复位时间为(57.7±3.5)min,手术时间为205(200,210)min,术中出血量为100(100,200)mL,残余位移为(7.55±3.51)mm。术后根据Matta评分标准评定骨折复位质量:优4例,良8例,可3例。14例患者术后获15.0(10.8,18.0)个月随访,1例患者失访。14例获随访患者的骨折愈合时间为3.6(3.2,4.7)个月;末次随访时Majeed功能评分为(83.4±6.4)分,其中优4例,良10例。结论:RAFR可以为大多数Tile C1-2型骨盆骨折患者完成精准、微创的闭合复位,术后骨折复位质量和近期疗效良好。

ObjectiveTo investigate the short-term efficacy of the intelligent robot-assisted fracture reduction system(RAFR)in the treatment of Tile-type C1-2 pelvic fractures.MethodsA retrospective study was conducted to analyze the clinical data of the 15 patients who had been treated for Tile-type C pelvic fractures at Department of Orthopedic Trauma,Foshan Hospital of Traditional Chinese Medicine between June 2022 and November 2023.The cohort were 7 males and 8 females,with an age of(51.6±22.1)years and a body mass index of(22.35±2.14)kg/m 2.According to the Tile classification,there were 9 cases of type C1 and 6 cases of type C2.The interval from injury to surgery was(11.3±3.9)days.Minimally invasive closed reduction and internal fixation of pelvic fractures were performed with the assistance of RAFR system.The anterior pelvic ring was fixed with percutaneous hollow screws from the pubic branch,and the posterior pelvic ring fixed with percutaneous hollow screws from the sacroiliac joint.If necessary,external fixation brackets and internal stent fixation technique for the anterior pelvic ring were used to enhance the stability of the pelvic ring.The frequency and time of intraoperative fluoroscopy,reduction time,surgical time,intraoperative bleeding volume,fracture reduction quality,follow-up time,fracture healing time,pelvic function recovery at the last follow-up,and incidence of complications were recorded.ResultsWith the assistance of RAFR system,15 patients were all successfully treated with minimally invasive closed reduction and internal fixation for pelvic fractures.For this cohort,intraoperative fluoroscopy frequency was 31(20,55)times,fluoroscopy time 25.8(18.0,33.0)seconds,reduction time(57.7±3.5)minutes,surgical time 205(200,210)minutes,intraoperative bleeding volume 100(100,200)mL,and residual displacement(7.55±3.51)mm.According to the Matta scoring,the postoperative quality of fracture reduction was evaluated as excellent in 4 cases,as good in 8 cases,and as fair in 3 cases.Fourteen patients were followed up for 15.0(10.8,18.0)months after surgery,and 1 patient was lost to the follow-up.The fracture healing time for the 14 patients was 3.6(3.2,4.7)months.The Majeed functional score at the last follow-up was(83.4±6.4)points,giving 4 excellent and 10 good cases.ConclusionThe RAFR system can facilitate precise and minimally invasive closed reduction for the majority of patients with Tile-type C1-2 pelvic fracture,achieving satisfactory fracture reduction quality and short-term efficacy.