Zheng Yugeng,Ma Hong,Li Liuyang,et al.Closed reduction and internal fixation for Delbet type Ⅱ/Ⅲ femoral neck fractures in children assisted by surgical robotic system[J].Journal of Clinical Pediatric Surgery,,22():1164-1169.[doi:10.3760/cma.j.cn101785-202303002-013]
Closed reduction and internal fixation for Delbet type Ⅱ/Ⅲ femoral neck fractures in children assisted by surgical robotic system
- Keywords:
- Femoral Neck Fractures; Robotic Surgical Procedures; Closed Fracture Reduction; Fracture Fixation; Internal; Child
- Abstract:
- Objective To evaluate the clinical effect of closed reduction and internal fixation surgery for the treatment of Delbet type II and III femoral neck fractures in children assisted by surgical robotic system.Methods A total of 54 children (54 hips) with femoral neck fracture who were hospitalized in Foshan Hospital of Traditional Chinese Medicine from January 2018 to August 2022 were enrolled in this study.The general clinical data of the patients were recorded,such as follow-up time,gender,age,affected side,fracture classification,the time from injury to surgery,and the above data were statistically analyzed.Patients were divided into the observation group and the control group according to different surgical methods.The observation group underwent robot-assisted closed reduction and internal fixation surgery,while the control group underwent traditional closed reduction and internal fixation surgery.The duration of operation,the guide needle threading times,the deviation angle between the inserted screws and the femoral neck-shaft angle,the parallelism between the inserted screws,the therapeutic effect was evaluated at the last follow-up,and the occurrence of complications were statistically analyzed in the two groups.Results A total of 54 cases (54 hips) were included in this study and followed up,with 26 cases in the observation group and 28 cases in the control group.There was no statistically significant difference in the general clinical data between the two groups (P>0.05).There was no significant difference in the average operation duration between the two groups (P>0.05).The average guide needle threading times in observation group(4.15±1.74) was significantly lower than that in control group(10.93±2.91),the difference was statistically significant(t=-10.301,P<0.05).The deviation angle between the inserted screws and the femoral neck-shaft angle on the first postoperative X-ray in the observation group 0.87°(0.51°,1.53°) was better than that in the control group3.57°(2.45°,5.57°),the difference was statistically significant(Z=-5.523,P<0.05).The parallelism between screws on the first postoperative X-ray in the observation group0.93°(0.52°,1.65°) was better than that in the control group2.44°(1.50°,3.13°),the difference was statistically significant(Z=-4.025,P<0.05).At the last follow-up,according to Ratliff criteria,there was no significant difference(χ2=1.671,P>0.05) in the treatment effect between the observation group(excellent 20 cases,good 3 cases,poor 3 cases) and the control group (excellent 17 cases,good 6 cases,poor 5 cases).During the follow-up period,the incidence of complications in the observation group was 23.1% (6/26),which was lower than 39.3% (11/28) in the control group,but the difference was no statistical significance(χ2=1.642,P>0.05).Conclusions The closed reduction and internal fixation surgery assisted by surgical robotic system in the treatment of femoral neck fractures in children can reduce the guide needle threading times,improve the accuracy of screws placement,and achieve good therapeutic effect.
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Memo
收稿日期:2023-3-1。
通讯作者:郭跃明,Email:guo_yuemming2008@126.com