智能机器人辅助经皮固定骨盆骨折

Intelligent robot-assisted percutaneous fixation of pelvic fractures

[目的]介绍智能机器人辅助骨盆复位后经皮固定骨盆骨折的手术技术和初步临床疗效。[方法]2022年6月—2023年1月,15例骨盆骨折患者均接受了智能机器人辅助经皮固定治疗。术前采集患者骨盆CT资料,固定示踪器,将术中CT数据与术前CT图像配准后,分别在骨盆两侧置入相应的Schantz钉,通过规划设计复位路径后,机械臂自动运转将患侧骨盆移动到目标位置,实现骨盆闭合复位。最后根据骨盆类型采用空心螺钉、INFIX内固定等方式固定。[结果]所有患者均顺利完成手术,未出现神经血管损伤、切口感染等并发症。手术时间平均(339.9±116.2)min,术中出血量平均(140.4±102.6)ml。残留移位平均(6.6±3.4)mm。Matta评分优良率为86.7%。[结论]机器人智能复位能够实现大多数移位性骨盆骨折的闭合复位,其操作安全、疗效显著,具有临床推广意义,值得进一步深入研究。

[Objective]To describe the surgical technique and preliminary clinical outcomes of intelligent robot-assisted percutaneous fixation of pelvic fractures.[Methods]A total of 15 patients underwent intelligent robot-assisted percutaneous fixation for pelvic fractures from June 2022 to January 2023.Preoperative CT data of the patient's pelvis were collected and the tracer was fixed.As intraoperative CT data were matched with the preoperative CT images,the corresponding Schantz pins were placed on both sides of the pelvis.After planning and designing the path of the pelvic reduction,the robotic arm was automatically operated to pull the affected pelvic side aiming the target position to achieve closed pelvic reduction.Finally,pelvic fixation was conducted by placement of cannulated screws,INFIX internal fixation or external frame depending on the concrete condition of pelvis.[Results]All patients had the surgery completed successfully,without postoperative complications such as neurovascular injury or incision infection,whereas with operation time of(339.9±116.2)min,intraoperative blood loss of(140.4±102.6)ml,and residual fracture displacement on images of(6.6±3.4)mm.According to the Matta criteria,the excellent and good rate of fracture reduction was of 86.7%.[Conclusion]This intelligent robotic-assisted reduction does achieve satisfactory closed reduction of displaced pelvic fracture in most cases,is a safe and efficient tool,which deserves to be studied furtherly indepth.