骨科创伤机器人辅助PFNA内固定治疗老年股骨粗隆间骨折的效果

doi:10.3969/j.issn.1003-9198.2023.05.014

摘要/Abstract

摘要： 目的探讨骨科创伤机器人辅助防旋股骨近端髓内钉(PFNA)内固定治疗老年股骨粗隆间骨折的临床效果。方法选择南昌县人民医院2020年9月至2021年9月收治的43例行PFNA内固定治疗的老年股骨粗隆间骨折病人,根据手术方式分为骨科创伤机器人辅助PFNA内固定治疗组(机器人组,21例)和徒手行PFNA内固定组(徒手组,22例)。比较2组术中透视次数、手术时间、术中出血量、开口导针穿刺次数、术后3个月Harris髋关节功能评分等指标。结果机器人组透视次数、开口导针穿刺次数、术中出血量显著少于徒手组,手术时间显著短于徒手组,差异均有统计学意义(P<0.01)。机器人组术后3个月髋关节功能Harris评分优秀率为81.0%,徒手组为45.5%,差异有统计学意义(P<0.05)。结论应用骨科创伤机器人辅助股骨粗隆间骨折闭合复位PFNA内固定,在精准定位开口位置,减少开口导针穿刺次数、术中透视次数、手术时间、术中出血量以及提高病人术后髋关节功能方面均具有优势。

关键词: 骨科创伤机器人, 防旋股骨近端髓内钉, 股骨粗隆间骨折, 老年人

Abstract: Objective To investigate the clinical effect of traumatic orthopedic robot assisting proximal femoral nail antirotation(PFNA) internal fixation for intertrochanteric fracture in the elderly patients. Methods A total of 43 elderly patients with femoral intertrochanteric fracture receiving the treatment of PFNA internal fixation in Nanchang County People's Hospital from September 2020 to September 2021 were selected.According to the surgical methods, the patients were divided into the robot group(n=21,receiving the treatment of PFNA internal fixation assisted by traumatic orthopedic robot) and the freehand group(n=22,receiving the treatment of traditional PFNA internal fixation). The fluoroscopy frequency, operation time, the volume of intraoperative blood loss, the puncturing times of guiding needle, and Harris hip score 3 months after operation were compared between the two groups. Results The fluoroscopy frequency, operation time, the volume of intraoperative blood loss, and the puncturing times of guiding needle in the robot group were lower than those in the freehand group(all P<0.01). Three months after surgery, the excellent rate of Harris hip score was 81.0% in the robot group, compared with 45.5% in the freehand group(P<0.05). Conclusions Applying traumatic orthopaedic robot to assist PFNA internal fixation in the elderly patients with femoral intertrochanteric fracture shows advantages in accurately locating the opening position, reducing the times of guiding needle adjustment and intraoperative fluoroscopy, shortening operation time, reducing intraoperative bleeding and improving the postoperative hip function of the patients.

Key words: traumatic orthopedic robot, proximal femoral nail antirotation, femoral intertrochanteric fracture, aged

中图分类号:

R 683.42

刘明军, 万先亮, 李洪波, 吴自强, 黄之春. 骨科创伤机器人辅助PFNA内固定治疗老年股骨粗隆间骨折的效果[J]. 实用老年医学, 2023, 37(5): 491-494.

LIU Ming-jun, WAN Xian-liang, LI Hong-bo, WU Zi-qiang, HUANG Zhi-chun. Effect of traumatic orthopaedic robot assisting PFNA internal fixation in the treatment of femoral intertrochanteric fracture in elderly patients[J]. Practical Geriatrics, 2023, 37(5): 491-494.

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