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  • Title: [Orthopedic robot based on 5G technology for remote navigation of percutaneous screw fixation in pelvic and acetabular fractures].
    Author: Zhao B, Li J, Zhao C, Su Y, Han W, Wu X, Jiang X, Wang J.
    Journal: Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi; 2022 Aug 15; 36(8):923-928. PubMed ID: 35979780.
    Abstract:
    OBJECTIVE: To investigate the accuracy and safety of percutaneous screw fixation for pelvic and acetabular fractures with remote navigation of orthopedic robot based on 5G technology. METHODS: Between January 2021 and December 2021, 15 patients with pelvic and/or acetabular fractures were treated with percutaneous screws fixation which were placed by remote navigation of orthopedic robot based on 5G technology. There were 8 males and 7 females. The age ranged from 20 to 98 years, with an average of 52.1 years. The causes of trauma included traffic accident injury in 6 cases, falling from height injury in 6 cases, fall injury in 2 cases, and heavy object smashing injury in 1 case. The time from injury to operation ranged from 3 to 32 days, with an average of 10.9 days. There were 8 cases of simple pelvic fractures, 2 simple acetabular fractures, and 5 both pelvic and acetabular fractures. There were 7 cases of pelvic fractures of Tile type B2, 2 type B3, 1 type C1, and 3 type C2; 4 cases of unilateral anterior column fracture of the acetabulum, 2 bilateral anterior column fractures, and 1 anterior wall fracture. CT images within 5 days after operation were collected for screw position assessment. The screw planning time and guidewire placement time were recorded, as well as the presence of intraoperative adverse events and complications within 5 days after operation. RESULTS: All patients achieved satisfactory surgical results. A total of 36 percutaneous screws were inserted (20 sacroiliac screws, 6 LC Ⅱ screws, 9 anterior column screws, and 1 acetabular apical screw). In terms of screw position evaluation, 32 screws (88.89%) were excellent and 4 screws (11.11%) were good; there was no screw penetrating cortical bone. The screw planning time ranged from 4 to 15 minutes, with an average of 8.7 minutes. The guidewire placement time ranged from 3 to 10 minutes, with an average of 6.8 minutes. The communication delayed in 2 cases, but the operation progress was not affected, and no serious intraoperative adverse events occurred. No delayed vascular or nerve injury, infection, or other complications occurred within 5 days after operation. No cases need surgical revision. CONCLUSION: The fixation of pelvic and acetabular fractures by percutaneous screw with remote navigation of orthopedic robot based on 5G technology is accurate, safe, and reliable. 目的: 探讨基于5G技术的骨科机器人远程导航辅助植入经皮骨盆通道螺钉固定骨盆及髋臼骨折的准确性和安全性。. 方法: 2021年1月—12月，采用基于5G技术的骨科机器人远程导航辅助植入经皮骨盆通道螺钉治疗15例骨盆和/或髋臼骨折患者。男8例，女7例；年龄20～98岁，平均52.1岁。致伤原因：交通事故伤6例，高处坠落伤6例，摔伤2例，重物砸伤1例。受伤至手术时间3～32 d，平均10.9 d。单纯骨盆骨折8例，单纯髋臼骨折2例，骨盆及髋臼均骨折5例。骨折分型：骨盆骨折Tile B2型7例，B3型2例，C1型1例，C2型3例；髋臼单侧前柱骨折4例，双侧前柱骨折2例，前壁骨折1例。记录术中螺钉规划时间、导针置入时间及有无不良事件发生，收集患者术后5 d内CT图像评价螺钉位置准确性，以及术后5 d内并发症发生情况。. 结果: 15例患者均顺利完成手术；共植入经皮骨盆通道螺钉36枚，其中骶髂螺钉20枚、LCⅡ螺钉6枚、前柱螺钉9枚、髋臼顶螺钉1枚；螺钉位置准确性评价获优32枚（88.89%）、良4枚（11.11%），无螺钉穿透皮质骨。螺钉规划时间为4～15 min，平均8.7 min；导针置入时间3～10 min，平均6.8 min。2例存在术中通信延迟问题，但均未影响手术进程，未出现严重术中不良事件。术后5 d内均未出现延迟性血管、神经损伤及感染等并发症，无需再次手术翻修。. 结论: 基于5G技术的骨科机器人远程导航辅助植入经皮骨盆通道螺钉固定骨盆和髋臼骨折准确、安全、可靠。.
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