机器人联合提拉钉复位空心钉固定难复性股骨颈骨折
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杜公文,主治医师,博士在读,研究方向:骨折创伤,(电话)15209859297,(电子信箱)dugongwen@126.com

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R683.42

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国家重点研发计划资助项目(编号:2018YFC0114708)


Robot combined with lifting pin for reduction and cannulated screw internal fixation of refractory femoral neck fracture
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    摘要:

    [目的] 介绍机器人联合辅助提拉闭合复位治疗难复性股骨颈骨折的手术技术和临床效果。[方法] 2018 年 1 月— 2020 年 12 月采用上述技术治疗难复位性股骨颈骨折 15 例。首先机器人引导下置入 3 枚空心钉导针,不穿过骨折线,股骨头置入 1 枚拉杆钉,透视下拉杆钉和手法施加复位力,使骨折达到满意复位,将 3 根空心钉导针穿过骨折线至股骨头下,最后空心钉固定。[结果] 15 例患者均顺利完成手术,术中无神经、血管损伤等严重并发症,术后 1 年髋关节 Harris 评分平均 (88.67±14.04) 分。1 例因过早下地致固定失败,其余患者末次随访时均恢复伤前运动水平。影像方面,所有患者术后均达到 Garden 对线 I 级复位,除上述 1 例患者,所有患者均骨折愈合,无股骨头坏死。[结论] 机器人联合辅助提拉复位可有效治疗难复性股骨颈骨折,具有放射损害低、骨折复位质量高、内固定精准的优点。

    Abstract:

    [Objective] To introduce the surgical technique and preliminary clinical outcomes of robot combined with lifting pin for re- duction and cannulated screw internal fixation of refractory femoral neck fracture. [Methods] From January 2018 to December 2020, 15 pa- tients were treated with the above techniques for refractory femoral neck fracture. First of all, 3 cannulated screw guide pins were placed un- der the guidance of robot, without passing through the fracture line, and a lifting pin was placed into the femoral head. The reduction force was applied by the lifting pin and manipulations to achieve satisfactory reduction of the fracture. Subsequently, the guide pin for cannulated screw guide were driven to pass through the fracture line into the femoral head, and finally the cannulated screws was inserted to finish the internal fixation. [Results] All the 15 patients had operation completed successfully, without neurovascular injury and other serious compli- cations, and were marked Harris score of (88.67±14.04) one year postoperatively. Except a patient who failed fixation due to premature walking, all the patients returned to their pre-injury activity level at the latest follow-up. In terms of imaging, all patients achieved grade I reduction based on Garden alignment scale after surgery. Except the patient abovementioned, all patients achieved fracture healing without femoral head necrosis. [Conclusion] The robot combined with lifting pin for reduction and cannulated screw internal fixation does effective- ly treat the refractory femoral neck fracture, with advantages of low radiation exposure, high fracture reduction quality and accurate internal fixation placement.

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杜公文,申才良,张复文,等. 机器人联合提拉钉复位空心钉固定难复性股骨颈骨折[J]. 中国矫形外科杂志, 2022, 30 (14): 1299-1302. DOI:10.3977/j. issn.1005-8478.2022.14.10.
DU Gong-wen, SHEN Cai-liang, ZHANG Fu-wen, et al. Robot combined with lifting pin for reduction and cannulated screw internal fixation of refractory femoral neck fracture[J]. Orthopedic Journal of China , 2022, 30 (14): 1299-1302. DOI:10.3977/j. issn.1005-8478.2022.14.10.

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  • 收稿日期:2022-01-01
  • 最后修改日期:2022-05-30
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  • 在线发布日期: 2023-06-29
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