[Effectiveness of Reduction Robot Combined with Navigation Robot-Assisted Minimally Invasive Treatment for Tile Type B Pelvic Fractures].

Jiangbo Liao, Yonghong Dai,Zhengjie Wu,Yanhui Zeng, Canhui Li, Xuelin Wang,Junqiang Wang,Chunpeng Zhao,Xinbao Wu

Chinese Journal of Reparative and Reconstructive Surgery（2024）

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Abstract

Objective:To explore the effectiveness of reduction robot combined with navigation robot-assisted minimally invasive treatment for Tile type B pelvic fractures. Methods:Between January 2022 and February 2023, 10 patients with Tile type B pelvic fractures were admitted. There were 6 males and 4 females with an average age of 45.5 years (range, 30-71 years). The fractures were caused by traffic accident in 5 cases, bruising by heavy object in 3 cases, and falling from height in 2 cases. The interval between injury and operation ranged from 4-13 days (mean, 6.8 days). There were 2 cases of Tile type B1 fractures, 1 case of Tile type B2 fracture, and 7 cases of Tile type B3 fractures. After closed reduction under assistance of reduction robot, the anterior ring was fixed with percutaneous screws with or without internal fixator, and the posterior ring was fixed with sacroiliac joint screws under assistance of navigation robot. The time of fracture reduction assisted by the reduction robot was recorded and the quality of fracture reduction was evaluated according to the Matta scoring criteria. The operation time, intraoperative fluoroscopy frequency and time, intraoperative bleeding volume, and incidence of complications were also recorded. During follow-up, the X-ray film of pelvis was taken to review the fracture healing, and the Majeed score was used to evaluate hip joint function. Results:The time of fracture reduction was 42-62 minutes (mean, 52.3 minutes). The quality of fracture reduction according to the Matta scoring criteria was rated as excellent in 4 cases, good in 5 cases, and poor in 1 case, with excellent and good rate of 90%. The operation time was 180-235 minutes (mean, 215.5 minutes). Intraoperative fluoroscopy was performed 18-66 times (mean, 31.8 times). Intraoperative fluoroscopy time was 16-59 seconds (mean, 28.6 seconds). The intraoperative bleeding volume was 50-200 mL (range, 110.0 mL). No significant vascular or nerve injury occurred during operation. All patients were followed up 13-18 months (mean, 16 months). X-ray films showed that all fractures healed with the healing time of 11-14 weeks (mean, 12.3 weeks). One case of ectopic ossification occurred during follow-up. At last follow-up, the Majeed score was 70-92 (mean, 72.7), and the hip joint function was rated as excellent in 2 cases and good in 8 cases, with the excellent and good rate of 100%. Conclusion:The reduction robot combined with navigation robot-assisted minimally invasive treatment for Tile type B pelvic fractures has the characteristics of intelligence, high safety, convenient operation, and minimally invasive treatment, which can achieve reliable effectiveness.

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Key words

Pelvic fracture,robotic surgery,closed reduction,internal fixation

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【要点】：研究探讨了结合使用复位机器人和导航机器人辅助的微创治疗Tile B型骨盆骨折的有效性，结果显示该治疗方法具有较高的安全性、便利性和微创性，且效果可靠。

【方法】：通过在复位机器人的辅助下进行闭合复位，并用经皮螺丝固定前环（必要时配合内置固定器），在导航机器人辅助下用骶髂关节螺丝固定后环。

【实验】：2022年1月至2023年2月间，对10例Tile B型骨盆骨折患者进行了上述治疗，记录了骨折复位时间、手术时间、术中透视次数和时间、术中出血量以及并发症发生率，并在随访中使用X光片评估骨折愈合情况和Majeed评分评估髋关节功能。实验数据集未在文中明确提及。结果显示复位质量优良率为90%，骨折愈合时间为11-14周，髋关节功能优良率为100%。