目的

探讨智能骨盆骨折微创复位机器人系统治疗不稳定型骨盆骨折的早期疗效，并分析其临床优势、局限性及注意事项。

方法

回顾性分析2022年6月至2023年11月于佛山市中医院利用该机器人系统治疗的25例不稳定型骨盆骨折患者的病历资料。其中TileB型5例，TileC型20例。在机器人系统辅助下完成微创闭合复位。手术前后拍摄骨盆CT及前后位、出口位、入口位X线片，根据X线及CT影像测量前后环复位前后的最大位移，采用Matta标准评估复位质量。记录前后环复位前后的最大位移、透视频率、透视时间、复位时间、手术时间、术中出血量，并计算复位前后环所需的距离。术后记录骨折愈合时间及随访时间，并利用Majeed评分系统进行功能评价。

结果

在机器人系统辅助下，所有患者都成功完成了微创闭合复位。前后环复位前的最大位移分别为（16±7）mm、（9±6）mm。透视次数为31（19，58）次，透视时间为（31±16）s，复位时间为（59±4）min，手术时间为206（200，213）min，术中失血量为100（50，160）ml，前后环复位后的最大位移分别为2.1（0，7.6）mm、3.8（1.4，7.9）mm。复位前后环所需的距离分别为14（4，18）mm、4.0（1.8，6.6）mm。根据Matta标准，前后环的复位质量均为：优15例、良7例、可2例，优良率为91.7%。24例患者获得16（14，19）个月随访，骨折愈合时间为3（3，4）个月，末次随访时Majeed功能评分为（85±8）分，其中优9例，良16例，优良率为100%。

结论

在本研究中，该系统可以为大多数不稳定型骨盆骨折患者完成精准、微创的闭合复位，可以获得良好的复位质量和早期疗效。

Objective

To discuss the early efficacy of the intelligent minimally invasive reduction robot system for pelvic fractures in the treatment of unstable pelvic fractures， and to analyze its clinical advantages， limitations and precautions.

Methods

A retrospective evaluation was conducted on 25 patients with unstable pelvic fractures treated by the robot system at the trauma orthopedics department of Foshan Traditional Chinese Medicine Hospital between June 2022 and November 2023. According to the Tile classification， there were 20 cases of type C and five cases of type B fractures. Minimally invasive closed reduction of pelvic fractures were performed with the assistance of the robot system. Pelvic CT scans and X-ray images at anteroposterior， outlet， and inlet positions were taken before and after surgery. The maximum displacement of the anterior and posterior pelvic rings before reduction and the maximum residual displacement of anterior and posterior pelvic rings after reduction were measured according to X-ray and CT images， and the quality of fracture reduction was evaluated by Matta criteria. The maximum displacement of the anterior and posterior pelvic rings before reduction， fluoroscopy frequency and time， reduction time， operation time，intraoperative blood loss， and maximum residual displacement of anterior and posterior pelvic rings after reduction were documented， and the distance required for the robotic arm to reduce the anterior and posterior pelvic rings was calculated. The fracture healing time and postoperative monitoring period were recorded， and the Majeed scoring system was used for functional evaluation.

Results

With the assistance of the robot system， 25 patients were all successfully treated with minimally invasive closed reduction for pelvic fractures. The average maximum displacement before reduction of the anterior pelvic ring was （16±7） mm. The average maximum displacement before reduction of the posterior pelvic ring was （9±6） mm. The intraoperative fluoroscopy frequency was 31 （19，58） times. The average fluoroscopy time was （31±16） s. The average reduction time was （59±4） min. The surgery time was 206 （200，213） min. The intraoperative blood loss was 100 （50，160） ml . The maximum residual displacement after reduction of the anterior and posterior pelvic rings were 2.1 （0， 7.6） mm， 3.8 （1.4，7.9）respectively. The distance required for the robotic arm to reduce the anterior and posterior pelvic rings were 14 （4，18） mm， 4.0 （1.8，6.6） mm respectively. According to Matta criteria， the reduction quality of both the anterior and posterior pelvic ring was excellent in 15 cases， good in seven cases， and fair in two cases， with a good-toexcellent rate of 91.7%. The fracture healing time was 3 （3， 4） months. Follow-up time for the 24 cases was 16 （14，19） months， with the Majeed functional score （85±8） on average. Nine cases scored excellent， and 16 cases were good， with a good-to-excellent rate of 100%.

Conclusion

In this study， the robot system can facilitate precise and minimally invasive closed reduction for the majority of patients with unstable pelvic fractures， achieving satisfactory fracture reduction quality and early efficacy.