桡骨远端骨折闭合复位机器人治疗Colles骨折的近期疗效观察OA

Objective To observe the short-term clinical efficacy of robot-assisted closed reduction for Colles fractures of the distal radius,and to explore a visualized,precise,and programmable fracture reduction protocol.Methods A total of 60 patients with distal radius fractures treated between January 2023 and December 2023 were selected and divided into robot-as-sisted reduction group and manual reduction group(30 cases each).In the robot-assisted reduction group,there were 13 males and 17 females,with a median age of 59.00(53.50,61.75)years.Patients in this group underwent closed reduction of distal radius fractures assisted by a robotic system.The system utilizes X-ray imaging to perform intelligent diagnosis of fracture types and generates an automated reduction plan.After physician review,the operator manipulates the joystick on the control console to guide the robotic arm,achieving visualization,precision,and standardization during fracture reduction.Following reduction,the limb was immobilized using small splints.In the manual reduction group,there were 12 males and 18 females,with a medi-an age of 59.00(55.00,63.75)years.Patients underwent reduction using the Wumen Medical School technique for distal ra-dius fractures.The procedure involved massaging the palmar and dorsal muscle groups of the wrist to mobilize displaced frac-ture fragments,followed by counter-traction to correct shortening displacement.Subsequently,lifting and pressing maneuvers,along with compression,were applied to correct dorsal-palmar and lateral displacement.After reduction,small splints were used for immobilization.The study compared the success rate of primary reduction between the two groups,as well as changes in ra-diographic parameters before reduction,immediately after reduction,and at 3 months post-reduction.Wrist function was evalu-ated using the Cooney wrist score.Results All patients were followed up for more than 3 months.The success rate of primary reduction in the robot-assisted group was 96.67％(29/30),which was significantly higher than that in the manual reduction group[76.67％(23/30),P＜0.05].For the robot-assisted group,the ulnar inclination angle before reduction,immediately after reduction,and at 3 months post-reduction were(8.56±3.01)°,20.50(17.25,25.00)°,and(22.13±1.87)°,respectively;the corresponding values for the manual reduction group were(8.52±2.72)°,24.00(17.43,26.25)°,and(21.12±2.56)°.Regard-ing volar tilt,the values for the robot-assisted group at the three time points were(-7.13±5.80)°,12.30(10.30,15.43)°,and 12.50(11.63,14.00)°,respectively;while those for the manual reduction group were(-6.32±2.72)°,11.25(10.00,12.60)°,and 12.00(10.88,13.00)° for radial height,the measurements for the robot-assisted group were 3.70(1.15,6.08)mm,(8.71±0.85)mm,and(8.83±0.91)mm,respectively;compared to 3.30(1.75,6.23)mm,(7.90±1.39)mm,and(7.93±1.27)mm in the manual reduction group.Both groups showed statistically significant improvements in ulnar inclination angle,volar tilt,and radial height immediately after reduction and at 3 months post-reduction compared to pre-reduction values(P＜0.05).At 3 months post-reduction,the radial height in the robot-assisted group was superior to that in the manual reduction group,with a statistically significant difference(P＜0.05).However,no statistically significant differences were observed between the two groups regarding the excellent/good rate of wrist function or complications at 3 months post-reduction(P＞0.05).Conclusion The distal radius fracture reduction robot enables precise,effective,and safe reduction,significantly improving the success rate of primary reduction for distal radius fractures.It provides a visualized,precise,and proceduralized protocol for the treatment of distal radius fractures.