摘要
目的比较天玑机器人导航辅助下股骨颈动力交叉钉系统(FNS)与3枚中空螺钉(CCS)固定治疗青中年股骨颈骨折的早期效果。方法回顾性分析2023年1月至2024年9月期间武汉市第四医院骨科收治的60例青中年股骨颈骨折患者资料,均采用天玑机器人导航辅助定位。根据内固定方式不同将所有患者分为两组:FNS组26例,男16例,女10例;年龄49.5(42.8,60.8)岁;采用FNS固定治疗。CCS组34例,男18例,女16例;年龄48.5(38.0,55.0)岁;采用3枚CCS固定治疗。比较两组患者的手术时间、切口长度、术中出血量、术中透视次数、钻孔次数、骨折复位质量、住院时间、骨折愈合时间、完全负重时间,以及末次随访时股骨颈短缩长度、髋关节功能、并发症发生率等。结果两组患者术前一般资料的比较差异均无统计学意义(P>0.05),具有可比性。FNS组患者的手术时间[45.0(40.0,50.0)min]和切口长度[3.0(2.9,3.0)cm]显著短于CCS组患者[50.0(41.3,55.0)min、3.0(3.0,3.7)cm],术中透视次数[(18.0±3.2)次]和钻孔次数[2.0(2.0,2.0)次]显著少于CCS组患者[(20.1±3.7)、3.0(3.0,3.0)次],末次随访时股骨颈短缩长度[0.0(0.0,1.8)mm]显著短于CCS组患者[2.0(0.0,4.0)mm],髋关节Harris评分[92.0(90.0,94.0)分]显著高于CCS组患者[91.5(85.3,93.0)分]、大腿外侧激惹发生率[3.8%(1/26)]显著低于CCS组患者[26.5%(9/34)],差异均有统计学意义(P<0.05)。而两组患者的术中出血量、骨折复位质量、住院时间、骨折愈合时间、完全负重时间及其他并发症发生率等比较差异均无统计学意义(P>0.05)。结论天玑机器人导航辅助治疗青中年股骨颈骨折具有微创、精准的优势;FNS固定在缩短手术时间、减少术中透视次数和大腿外侧激惹、恢复髋关节功能等方面较CCS固定更有优势。
Objective To compare the early efficacy between fixation with femoral neck system(FNS)and fixation with 3 cannulated compression screws(CCS)in the treatment of femoral neck fractures under TINAVI robot-assisted navigation in young and middle-aged patients.Methods A retrospective study was conducted to analyze the data of 60 patients with femoral neck fracture who had been treated under TINAVI robot-assisted navigation at Department of Orthopaedics,Wuhan Fourth Hospital from January 2023 to September 2024.The patients were assigned into 2 groups based on their fixation method:an FNS group of 26 cases[16 males and 10 females with an age of 49.5(42.8,60.8)years]treated by fixation with FNS and a CCS group of 34 cases[18 males and 16 females with an age of 48.5(38.0,55.0)years]treated by fixation with 3 CCSs.The 2 groups were compared in terms of surgical time,incision length,intraoperative bleeding,intraoperative fluoroscopy frequency,drilling frequency,fracture reduction quality,hospital stay,fracture union time,and time to complete weight-bearing,as well as femoral neck shortening,hip function,and complications at the last follow-up.ResultsThere were no statistically significant differences in the preoperative baseline data between the 2 groups,indicating comparability(P>0.05).The surgical time[45.0(40.0,50.0)min]and incision length[3.0(2.9,3.0)cm]in the FNS group were significantly shorter than those in the CCS group[50.0(41.3,55.0)min,3.0(3.0,3.7)cm](P<0.05).The fluoroscopy frequency[(18.0±3.2)times]and drilling frequency[2.0(2.0,2.0)times]in the FNS group were significantly lower than those in the CCS group[(20.1±3.7)times,3.0(3.0,3.0)times](P<0.05).At the last follow-up,the FNS group had significantly shorter femoral neck shortening[0.0(0.0,1.8)mm],significantly higher Harris hip score[92.0(90.0,94.0)points],and significantly lower incidence of lateral thigh irritation[3.8%(1/26)]than the CCS group[2.0(0.0,4.0)mm,91.5(85.3,93.0)points,and 26.5%(9/34)](P<0.05).No statistically significant differences were observed between the 2 groups in intraoperative bleeding,fracture reduction quality,hospital stay,fracture union time,time to full weight-bearing,or other complications(P>0.05).Conclusions Treatment of femoral neck fractures under TINAVI robot-assisted navigation in young and middle-aged patients demonstrates advantages of minimal invasion and accuracy.Compared with CCS fixation,FNS fixation is more advantageous in shortening surgical time,reducing intraoperative fluoroscopy and lateral thigh irritation,and restoring hip joint function.
作者
黄玉成
焦竞
陈明
马旋
熊文
胡家朗
王俊文
Huang Yucheng;Jiao Jing;Chen Ming;Ma Xuan;Xiong Wen;Hu Jialang;Wang Junwen(Department of Orthopaedics,Wuhan Fourth Hospital,Wuhan 430033,China)
出处
《中华创伤骨科杂志》
北大核心
2025年第12期1067-1074,共8页
Chinese Journal of Orthopaedic Trauma
基金
国家重点研发计划项目(2022YFC2407500)
武汉市科学技术局知识创新专项-曙光计划项目(2022020801020560)
武汉市卫健委医学科研项目(WX23A13)。
