骨科机器人辅助下F钉技术与倒三角平行钉治疗不稳定型股骨颈骨折的疗效比较

目的:比较天玑机器人辅助下F钉技术与倒三角平行钉内固定治疗不稳定型股骨颈骨折的临床疗效。方法:回顾性分析2019年12月至2021年4月运用天玑手术机器人经皮置入空心螺钉内固定治疗不稳定型股骨颈骨折72例,其中37例采用F钉内固定,男16例,女21例;年龄47～64(53.87±5.28)岁;依据Pauwels损伤分型,Ⅰ型1例,Ⅱ型19例,Ⅲ型17例;合并内科疾病8例;摔伤17例,车祸伤8例,高处坠落伤12例;受伤至手术时间29～49(35.00±7.34) h。另35例采用倒三角平行钉内固定,男13例,女22例;年龄46～63(52.36±5.05)岁;依据Pauwels损伤分型,Ⅰ型2例,Ⅱ型21例,Ⅲ型12例;合并内科疾病6例;摔伤15例,车祸伤9例,高处坠落伤11例;受伤至手术时间30～45(33.00±6.83)h。观察比较两组术中出血量、手术时间、术中透视次数、随访时间、骨折愈合时间及术后并发症,分别于术后6、12个月采用Harris评分对髋关节功能进行评价。结果:两组患者均定期随访,时间12～16个月。两组手术时间、术中出血量,术中透视次数比较,差异无统计学意义(P&g...

Comparison of the efficacy of TiRobot orthopaedic robot assisted F screw technique and inverted triangle parallel nail internal fixation in the treatment of unstable femoral neck fractures

Objective To compare the effectiveness of TiRobot assisted F screw technique and inverted triangle parallel nail internal fixation in the treatment of unstable femoral neck fractures.

Methods A retrospective analysis was conducted on 72 patients with unstable femoral neck fractures who were treated with percutaneous cannulated screw fixation assisted with TiRobot Orthopaedic robot from December 2019 to April 2021. Among them, 37 patients were treated with F screw internal fixation, including 16 males and 21 females, aged 47 to 64 years old with an average of (53.87±5.28) years old;According to Pauwels classification, there were 1 case of type Ⅰ, 19 cases of type Ⅱ, 17 cases of type Ⅲ;8 cases of combined medical diseases;17 cases of falling, 8 cases of traffic accident and 12 cases of falling from height;The time from injury to operation was 29 to 49 hours with average of (35.00±7.34) hours. Another 35 cases used internal fixation with an inverted triangle parallel nail, including 13 males and 22 females with an average age of 46 to 63 years old (52.36±5.05) years old;According to the Pauwels injury classification:there were 2 cases of type Ⅰ, 21 cases of type Ⅱ, 12 cases of type Ⅲ;6 cases of medical diseases, 15 cases of falling injury, 9 cases of traffic accident, 11 cases of falling injury;The time from injury to operation was 30 to 45 hours with an average of (33.00±6.83) h. The intraoperative blood loss, operation time, intraoperative fluoroscopy times, follow-up time, fracture healing time, postoperative complications were observed and compared between the two groups. The hip joint function was evaluated by Harris score at 6 months and 12 months after operation.

Results There was no significant difference in operation time, intraoperative blood loss, intraoperative fluoroscopy times and other intraoperative data between two groups(P>0.05). Both groups were followed up regularly, and the follow-up time was 12 to 16 months. The fracture healing time and Harris score of the F screw internal fixation group were better than those of the inverted triangle parallel nail internal fixation group (P<0.05). There was 1 case of femoral neck shortening in the F screw internal fixation group, 1 case of nonunion, 1 case of nail withdrawal, and 1 case of lower extremity deep vein thrombosis in the inverted triangle internal fixation group. The incidence of complications in the F screw internal fixation group was lower than that in the inverted triangle parallel nail internal fixation group(P<0.05).

Conclusion Percutaneous cannulated F screw technique using Tirobot navigation positioning system is a safe and effective treatment for patients with unstable femoral neck fractures. It can significantly shorten the fracture healing time, reduce the incidence of postoperative complications, significantly improve hip joint function, and improve the quality of life.