Ma Hong,Tang Xianneng,Guo Yueming.Comparative study of percutaneous in stu fixation of slipped capital femoral epiphysis assisted by surgical robotic system[J].Journal of Clinical Pediatric Surgery,,20():724-730.[doi:10.12260/lcxewkzz.2021.08.005]
Comparative study of percutaneous in stu fixation of slipped capital femoral epiphysis assisted by surgical robotic system
- CLC:
- R681.8;R726.8
- Abstract:
- Objective To evaluate the clinical efficacy of percutaneous in situ fixation of femoral head epiphyseal slip in children under robot navigation. Methods From January 2010 to January 2021, a total of 20 children with femoral head epiphyseal slippage were recruited. According to different treatment, they were divided into experimental group:8 children (8 hips) undergoing percutaneous orthotopic fixation under robot navigation, including 5 males (62.5%) and 3 females (37.5%);The mean age was (10.7±2.9) years. Control group:12 children (12 hips) traditional percutaneous orthotopic fixation, including 8 males (67%) and 4 females (33%);The mean age was (11.9±1.6) years. At preoperation and the final follow-up, hip function was assessed using the Harris hip score and Southwick Angle on postoperative radiographs was measured. Results All 20 patients (20 hips) were followed up for a mean period of (2-37)(15.3±6.0) months. At the last follow-up, Harris hip function score in experimental group recovered from (35.1±15.7) points preoperative surgery to (86.6±8.60) points and hip function significantly improved with statistical significance (P<0.05). Postoperative Southwick Angle declined by 29.7°(95%CI:16.9°-42.4°) as compared with pre-operation (P<0.05). Harris hip function score in control group recovered from (50.8±22.2) points at pre-operation to (82.2±7.9) points at the last follow-up and hip function improved with statistical significance (P<0.05). Postoperative Southwick Angle dropped by 16.5°(95%CI:2.2°-30.8°) as compared with pre-operation (P<0.05). Until the last follow-up, there was no occurrence of such adverse complications as wound infection, screw fracture, bone nonunion and necrosis of femoral head. Conclusion Percutaneous in situ fixation of pediatric femoral head epiphyseal spondylolisthesis under robot navigation is both safe and effective. With a decent prognosis, it offers the advantages of precision, mini-invasiveness and operative convenience. Compared with traditional operation, it may reduce the number of anesthetics, minimize blood loss and iatrogenic hip injury and lower the frequency of C-arm fluoroscopy in children.
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Memo
收稿日期:2021-02-25。
基金项目:佛山市卫生健康委员会科研课题（编号：20200446）
通讯作者:郭跃明,Email:guo_yueming2008@126.com