骨科机器人联合Starr骨盆复位架治疗Tile C型骨盆环骨折
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作者Author单位AddressE-Mail
姜刚强 JIANG Gang-qiang 宁波市第六医院创伤骨科, 浙江 宁波 315040 Department Orthopaedics, Ningbo No. 6 Hospital, Ningbo 315040, Zhejiang, China jianggangqianghqh@163.com 
焦福德 JIAO Fu-de 宁波市第六医院创伤骨科, 浙江 宁波 315040 Department Orthopaedics, Ningbo No. 6 Hospital, Ningbo 315040, Zhejiang, China  
应霁翀 YING Ji-chong 宁波市第六医院创伤骨科, 浙江 宁波 315040 Department Orthopaedics, Ningbo No. 6 Hospital, Ningbo 315040, Zhejiang, China  
虞天明 YU Tian-ming 宁波市第六医院创伤骨科, 浙江 宁波 315040 Department Orthopaedics, Ningbo No. 6 Hospital, Ningbo 315040, Zhejiang, China  
刘建磊 LIU Jian-lei 宁波市第六医院创伤骨科, 浙江 宁波 315040 Department Orthopaedics, Ningbo No. 6 Hospital, Ningbo 315040, Zhejiang, China  
庄云强 ZHUANG Yun-qiang 宁波市第六医院创伤骨科, 浙江 宁波 315040 Department Orthopaedics, Ningbo No. 6 Hospital, Ningbo 315040, Zhejiang, China  
期刊信息:《中国骨伤》2024年,第37卷,第5期,第445-450页
DOI:10.12200/j.issn.1003-0034.20221138
基金项目:
中文摘要:

目的:探讨骨科机器人联合Starr骨盆复位架治疗Tile C型骨盆环骨折的临床疗效。

方法:2019年10月至2021年5月采用机器人联合Starr骨盆复位架治疗14例Tile C型骨盆环骨折患者,男9例,女5例;年龄33~69 岁。14例患者均为新鲜闭合骨折且不合并股骨、胫腓骨骨折等损伤。入院后4~7 d完成手术,术中在可透视碳素床,通过Starr骨盆复位架牵引复位骨盆环,联合骨科机器人治疗C型骨盆环骨折。观察手术时间、出血量、单枚螺钉置入透视次数、骨折复位质量、患肢功能及并发症等。采用Matta评分标准进行放射学复位评价,末次随访采用Majeed骨盆功能评分系统进行临床疗效评价。

结果:14例患者均顺利完成手术,手术时间84~141 min,手术出血量20~50 ml,单枚螺钉置入透视次数4~9次。14例患者均获得随访,随访时间12~24个月。术后所有骨折获得骨性愈合,愈合时间3~7个月,未发现内固定断裂、螺钉松动、感染、神经损伤等并发症。依据Matta影像学复位评估标准:优9例,良4例,可1例。末次随访采用Majeed骨盆功能评分系统:优10例,良4例。

结论:机器人联合Starr骨盆复位架治疗C型骨盆环新鲜骨折操作简单、缩短了手术和麻醉时间、并发症少,降低了手术风险,实现了骨盆骨折的微创治疗。但对于陈旧性骨折,因骨折复位困难,该技术并不适用。对于螺钉进钉点区域粉碎的骨折,通道螺钉置入困难,建议采用其他方式固定。对于伴有骨盆外伤史或骨盆发育异常者,术前需仔细评估有无经皮螺钉通道,避免损伤神经、血管。
【关键词】骨科机器人  Starr骨盆复位架  骨盆骨折  螺钉  内固定
 
Treatment of Tile type C pelvic ring fracture using orthopedic robot combined with Starr pelvis reduction frame
ABSTRACT  

Objective To investigate the clinical effect of orthopedic robot combined with Starr pelvic reduction frame in the treatment of Tile type C pelvic ring fracture.

Methods From October 2019 to May 2021,14 patients with type C pelvic ring fracture were treated with robotic combined with Starr pelvic reduction frame,including 9 males and 5 females. The age ranged from 33 to 69 years. All the 14 patients had fresh closed fractures without femur,tibia and fibula fracture. Surgery was completed from 4 to 7 d after hospital admission. During the operation,the X-ray carbon bed was used,the pelvic ring was reduced by Starr pelvis reduction frame,and pelvic ring fracture was treated by orthopedic robot. Operation time,bleeding volume,fluoroscopy times of single screw placement,fracture reduction quality,affected limb function and complications were observed. Radiological reduction was evaluated using Matta scoring standard,and clinical efficacy was evaluated by Majeed pelvic function scoring system at the final follow-up.

Results All of 14 patients successfully completed the operation,the operation time was 84 to 141 min,the bleeding volume was 20 to 50 ml,and the fluoroscopy times of single screw insertion was 4 to 9 times. All of 14 patients were followed up for 12 to 24 months. The healing time was 3 to 7 months. No complications such as fracture of internal fixation,screw loosening,infection and nerve injury were found. According to the evaluation criteria of Matta imaging reduction,9 cases were excellent,4 cases were good,and 1 case was fair. At the final follow-up,Majeed pelvic function scoring system was used:10 cases were excellent,4 cases were good.

Conclusion The treatment of type C pelvic ring fracture with robotic combined Starr pelvis reduction frame is simple,time-saving,less trauma,less complications and effective.
KEY WORDS  Orthopedic robot  Starr pelvic reduction frame  Pelvic fracture  Screw  Internal fixation
 
引用本文,请按以下格式著录参考文献:
中文格式:姜刚强,焦福德,应霁翀,虞天明,刘建磊,庄云强.骨科机器人联合Starr骨盆复位架治疗Tile C型骨盆环骨折[J].中国骨伤,2024,37(5):445~450
英文格式:JIANG Gang-qiang,JIAO Fu-de,YING Ji-chong,YU Tian-ming,LIU Jian-lei,ZHUANG Yun-qiang.Treatment of Tile type C pelvic ring fracture using orthopedic robot combined with Starr pelvis reduction frame[J].zhongguo gu shang / China J Orthop Trauma ,2024,37(5):445~450
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