首都医科大学学报

• 智慧骨科及手术机器人临床应用 • 上一篇    下一篇

全机器人导航辅助髓内钉固定治疗老年股骨转子间骨折的临床研究

韩大成,王嘉龙,杨琦,司志勇,张亚奎,刘亮,王雪飞*   

  1. 首都医科大学附属北京潞河医院创伤骨科,北京 101149
  • 收稿日期:2025-01-23 修回日期:2025-08-17 出版日期:2025-10-22 发布日期:2025-10-22
  • 通讯作者: 王雪飞 E-mail:xuefeiw@vip.sina.com

Retrospective analysis of fully robot-navigated intramedullary nail fixation for elderly patients with intertrochanteric femoral fractures

Han Dacheng, Wang Jialong, Yang Qi, Si Zhiyong, Zhang Yakui, Liu Liang, Wang Xuefei*   

  1. Department of Trauma Orthopedics, Beijing Luhe Hospital, Capital Medical University,Beijing 101149,China
  • Received:2025-01-23 Revised:2025-08-17 Online:2025-10-22 Published:2025-10-22

摘要: 目的  探讨机器人全导航辅助近端股骨髓内钉与传统徒手手术的临床效果差异;分析机器人全导航辅助髓内钉固定技术在治疗老年人股骨转子间骨折中的可行性。方法  纳入2023年12月到2024年12月,在首都医科大学附属北京潞河医院创伤骨科进行手术的老年股骨转子间骨折的患者,根据手术方法将患者分为2组:全机器人组和传统组。全机器人组的手术方法是机器人全导航辅助的髓内钉内固定术,传统组采用徒手置入髓内钉内固定术。收集患者的基线数据和观察指标,比较组间是否存在差异。结果  组间基线数据差异无统计学意义(P > 0. 05)。全机器人组的术中出血量为(94. 28±9. 43)mL,传统组的术中出血量为(143. 00±11. 11) mL(P<0. 001);全机器人组的手术时间为(53. 06 ± 9. 89)min,传统组术时间为(66. 74 ± 10. 18)min(P<0. 001);全机器人组主钉皮肤切口长度为(3. 23 ± 0. 64) cm,传统组用于主钉皮肤切口长度为(4. 03 ± 0. 79)cm(P<0. 01)。全机器人组术后血红蛋白较术前下降了(12. 63 ± 4. 27)g/L,而传统组术后血红蛋白较术前下降了(17. 29 ± 4. 32)g/L(P=0. 018)。全机器人组术后6个月患侧肢体髋关节的Harris评分为优秀30例、良好10例、差3例;在传统组中,Harris评分优秀22例、良好15例、差6例(P=0. 198)。结论  采用全机器人导航辅助的髓内固定股骨转子间骨折具有微创和精确的优势,手术时间更短,出血量更少,与传统手术方法相比,对于减少老年患者的术后并发症具有潜在的优势。

关键词: 全机器人导航, 转子间骨折, 老年人, 髓内钉固定, 微创, 精确

Abstract: Objective  To investigate the clinical outcome differences between robotic-assisted intramedullary nailing and traditional manual surgery, and to analyze the advantages and feasibility of robotic-assisted intramedullary nail fixation in the treatment of intertrochanteric fractures in elderly patients. Methods  From December 2023 to December 2024, elderly patients with intertrochanteric fractures who underwent surgery at Department of Trauma Orthopedics, Beijing Luhe Hospital, Capital Medical University were included. Patients were divided into two groups based on the surgical method. The robotic-assisted group underwent robotic-assisted intramedullary nail fixation, while the traditional group received manual intramedullary nail fixation. Baseline data and observation indicators were collected and compared between the two groups to assess any differences. Results  There were no statistically significant differences in baseline data between the two groups (P > 0. 05). The intraoperative blood loss in the robotic-assisted group was (94. 28 ± 9. 43) mL, compared to (143. 00 ± 11. 11) mL in the traditional group (P<0. 001). The operative time in the robotic-assisted group was (53. 06 ± 9. 89) min, while in the traditional group, it was (66. 74 ± 10. 18) min (P<0. 001). The skin incision length for the main nail in the robotic-assisted group was (3. 23 ± 0. 64) cm, whereas in the traditional group, it was (4. 03 ± 0. 79) cm (P< 0. 01). Postoperative hemoglobin levels in the robotic-assisted group decreased by (12. 63 ± 4. 27) g/L, compared to (17. 29 ± 4. 32) g/L in the traditional group (P= 0. 018). At 6 months postoperatively, the Harris hip scores in the robotic-assisted group showed 30 cases of excellent, 10 good, and 3 poor outcomes, while in the traditional group, there were 22 excellent, 15 good, and 6 poor cases (P= 0. 198). Conclusion  Robotic-assisted intramedullary nailing for intertrochanteric fractures offers advantages such as minimally invasive and precise procedures, shorter operative times, and reduced blood loss. Compared to traditional surgical methods, it demonstrates certain benefits in reducing postoperative complications in elderly patients.

Key words: robotic-assisted navigation, intertrochanteric fracture, elderly, intramedullary nail fixation, minimally invasive, precision

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