【摘要】 [目的]评价机器人辅助经皮空心钉固定股骨颈骨折的临床疗效。[方法]回顾性分析2017年11月—2019年5月经皮空心钉固定股骨颈骨折68例患者的临床资料。根据术前医患沟通结果，32例采用机器人辅助置钉，36例徒手置钉。比较两组围手术期、随访和影像资料。[结果]机器人组手术时间、术中透视次数、导针定位次数、下地行走时间显著优于徒手组（P<0.05）。随访（31.4±6.8）个月，机器人组骨不连1例，股骨头坏死3例；徒手组骨不连2例，股骨头坏死5例。机器人组恢复完全负重活动时间显著早于徒手组（P<0.05）。随时间推移，两组的Harris评分、髋伸-屈、内-外旋ROM均显著增加（P<0.05）；术后1、3个月机器人组的Harris评分、ROMs均显著优于徒手组（P<0.05），但末次随访时两组间差异无统计学意义（P>0.05）。影像方面，两组术后Garden指数差异无统计学意义（P>0.05）。机器人组空心钉平行度、分散度均显著优于徒手组（P<0.05）。相应时点两组间在颈干角、Tonnis髋退变分级的差异均无统计学意义（P>0.05）。[结论]机器人辅助经皮空心钉固定股骨颈骨折可缩短手术时间，提高置钉精度，有利于髋关节功能的早期恢复。更多还原

【Abstract】 [Objective] To evaluate the clinical efficacy of robot-assisted percutaneous cannulated screw fixation of femoral neck fractures. [Methods] A retrospective study was done on 68 patients who received percutaneous cannulated screw fixation of femoral neck fractures from November 2017 to May 2019. According to preoperative doctor-patient communication, 32 patients received robot-assisted screw placement, while the remaining 36 patients were treated with freehand screw placement. The documents regarding to perioperative period, follow-up and radiographs were compared between the two groups. [Results] The robot group proved significantly superior to the freehand group in terms of operation time, intraoperative fluoroscopy times, guide pin positioning times and postoperative walking time(P<0.05). During the follow-up lasted for(31.4±6.8) months on a mean, the robot group had 1 case of nonunion and 3 cases of femoral head necrosis, whereas the freehand group had 2 cases of nonunion and 5 cases of femoral head necrosis. The robot group resumed full weight bearing activity significantly earlier than the freehand group(P<0.05). The Harris score, hip extension-flexion and internal-external rotation range of motions(ROMs) significantly increased in both groups over time(P<0.05), which in the robot group were significantly better than the freehand group at 1 and 3 months postoperatively(P<0.05), whereas became not statistically significant between the two groups at the latest follow-up(P>0.05). Radiographically, there was no significant difference in Garden index between the two groups(P>0.05), while the robot group was significantly superior to the freehand group in terms of the parallelism and dispersion of cannulated screw placement(P<0.05). However, there were no significant differences in neck-shaft angle and Tonnis grade for hip degeneration between the two groups at the corresponding time points(P>0.05). [Conclusion] Robot-assisted fixation of femoral neck fractures with cannulated screws does shorten the operation time, improve the accuracy of screw placement, and facilitate the early recovery of hip function.更多还原