机器人导航下改良Stoppa入路治疗骨盆髋臼骨折的临床效果研究OA

Objective:To investigate the efficacy of robot-assisted navigated screw placement with modified Stoppa approach for acetabular fractures.Methods:A prospective randomized controlled trial was conducted on 102 patients with acetabular fractures who were treated at the First Affiliated Hospital of Kangda College of Nanjing Medical University between November 2022 and April 2024.They were randomly divided into the control group(n=51)and the study group(n=51)using a random number table.Both groups underwent surgery via the modified Stoppa approach.The control group received conventional freehand screw fixation under guidance of C-arm X-ray fluoroscopy,while the study group underwent robot-navigated screw fixation.Perioperative indicators,stress markers,fracture reduction quality(excellent/good rate),modified Merle D'Aubigne and Postel scores,and postoperative complications were compared between the two groups.Results:The study group had significantly shorter operative time,fewer number of intraoperative fluoroscopies,less total intraoperative blood loss,fewer total drilling attempts,and a shorter length of hospital stay compared to the control group(P＜0.05).At 24 h and 72 h after surgery,the study group had significantly lower levels of stress markers than the control group(P＜0.05).The fracture reduction excellent/good rate was significantly higher in the study group than the control group.Furthermore,the modified Merle D'Aubigne and Postel scores at 3,6,and 12 months after surgery were significantly higher in the study group than those in the control group(P＜0.05).The incidence of postoperative complications was significantly lower in the study group than that in the control group(P＜0.05).Conclusion:The application of robot-navigated screw placement with the modified Stoppa approach can enhance surgical precision and safety,reduce surgical trauma and radiation exposure,effectively control perioperative stress response,promote postoperative recovery,and lower the risk of postoperative complications.