Efficacy of robot-assisted minimally-invasive sacroiliac screw fixation combined with LC-II external fixation in treatment of pelvic fractures
10.3760/cma.j.cn121113-20230328-00168
- VernacularTitle:机器人辅助骶髂螺钉内固定联合LC-Ⅱ螺钉外固定治疗骨盆骨折
- Author:
Nan ZUO
1
;
Guang YANG
;
Baochang QI
;
Tianhao ZHAO
;
Zhewen LIU
;
Zihang WANG
;
Dahui SUN
Author Information
1. 吉林大学第一医院骨科中心创伤骨科，长春 130021
- Keywords:
Pelvic;
Robotic surgical procedures;
Fracture fixation, internal;
External fixators
- From:
Chinese Journal of Orthopaedics
2023;43(19):1269-1276
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical efficacy of robot-assisted minimally invasive sacroiliac screw fixation combined with LC-II external fixation in the treatment of pelvic fracture.Methods:A retrospective analysis was conducted on 28 cases with pelvic fractures treated with robot-assisted minimally invasive sacroiliac screw fixation combined with LC-II external fixation from May 2018 to November 2022. There were 19 males and 9 females, with an average age of 43.4±16.9 years (range, 14-74 years). There was 1 case of B1 type, 1 case of B2 type, 4 cases of B3 type, 10 cases of C1 type, 9 cases of C2 type and 3 cases of C3 type by Tile classification. All the cases were treated with closed reduction, LC-II external fixation for the anterior lesions and robot-assisted minimally invasive sacroiliac screw fixation for the posterior lesions. The operation time, fluoroscopy time and excellent rate of screw placement were recorded. The quality of fracture reduction was evaluated by Matta's criteria, and the clinical effect was evaluated by Majeed score.Results:All the 28 cases successfully underwent the surgery. In 11 cases the fractures were reduced by the pelvic unlocking closed reduction device while in the other 17 cases manual reduction was applied. In this cohort, 43 screws were implanted. All the screw positions reached level I by Gras grading. The average fluoroscopy time was 16.3±5.2 s (range, 9-31 s) per screw. The average operation time was 154.9±54.7 min (range, 55-226 min). According to the Matta's criteria, the reduction was rated as excellent in 19 cases, good in 7 cases, fair in 2 cases, yielding an excellent or good rate of 93% (26/28). No iatrogenic neurovascular injury was found in all the 28 patients. The average follow-up was 18.3±7.3 months (range, 4-31 months). The fractures healed at 3.6±1.1 months (range, 2-6 months) after the surgeries. At the final follow-up, the results of the Majeed scores were rated as excellent in 13 cases, good in 11 cases, fair in 3 cases and poor in 1 case, with an excellent or good rate of 86% (24/28).Conclusion:The technique of robot-assisted minimally invasive sacroiliac screw fixation combined with LC-II external fixation used in the treatment of pelvic fracture showed good clinical results.
