Dalian Medical University, Dalian, 116044, China.
Department of Orthopedics, Northern Jiangsu People's Hospital, Clinical Medical College, Yangzhou University, Yangzhou, 225001, China.
J Orthop Surg Res. 2023 Aug 28;18(1):633. doi: 10.1186/s13018-023-04070-3.
Robots are being used in a wide range of surgical procedures. However, in clinical practice, the efficacy of orthopedic robotic-assisted treatment of femoral neck fractures is still poorly reported, particularly in terms of screw placement accuracy, femoral neck fracture healing rates and postoperative functional recovery. Moreover, there is a lack of comparative analysis between robot-assisted surgery and traditional surgical approaches.
The purpose of this study was to compare the clinical outcomes of patients with femoral neck fractures treated with TiRobot-assisted hollow screw fixation with those of patients with femoral neck fractures treated with traditional surgical approaches.
This study included 112 patients with femoral neck fracture who were treated from March 2017 to October 2021 with percutaneous hollow screw internal fixation. These included 56 cases in the TiRobot-assisted surgery group and 56 cases in the standard surgery group. After at least 1 year of follow-up, the treatment outcomes of the two groups were compared, including the amount of intraoperative bleeding, the duration of intraoperative fluoroscopy, the number of guide pin positioning adjustments, the length of hospital stay, the accuracy rate of screw placement, the final Harris Hip Score, the fracture healing rate, and the rate of femoral head necrosis. Statistical analysis software was used to process and analyze the result.
The TiRobot-assisted group had a statistically significant improvement over the control group in terms of intraoperative bleeding, the duration of intraoperative fluoroscopy, the number of guide pin positioning adjustments, length of hospital stay, accuracy of screw placement and incidence of femoral head necrosis (P < 0.05). There was no statistically significant difference in time to surgery, final Harris hip score and fracture healing rate (P > 0.05).
This study shows that TiRobot-assisted surgery has the advantages of short hospital stay, high safety, minimally invasive, high success rate of nail placement, and can reduce the amount of intraoperative radiation and the incidence of femoral head necrosis, thus achieving satisfactory clinical outcomes, and is worthy of clinical promotion.
机器人已广泛应用于各种外科手术中。然而,在临床实践中,骨科机器人辅助治疗股骨颈骨折的疗效仍报道较少,尤其是在螺钉放置准确性、股骨颈骨折愈合率和术后功能恢复方面。此外,机器人辅助手术与传统手术方法之间缺乏比较分析。
本研究旨在比较 TiRobot 辅助空心螺钉固定治疗股骨颈骨折患者与传统手术治疗股骨颈骨折患者的临床结果。
本研究纳入了 2017 年 3 月至 2021 年 10 月采用经皮空心螺钉内固定治疗的 112 例股骨颈骨折患者。其中,TiRobot 辅助手术组 56 例,标准手术组 56 例。至少随访 1 年,比较两组患者的治疗结果,包括术中出血量、术中透视时间、导针定位调整次数、住院时间、螺钉放置准确率、最终 Harris 髋关节评分、骨折愈合率和股骨头坏死率。使用统计分析软件对结果进行处理和分析。
与对照组相比,TiRobot 辅助组在术中出血量、术中透视时间、导针定位调整次数、住院时间、螺钉放置准确率和股骨头坏死发生率方面均有显著改善(P<0.05)。手术时间、最终 Harris 髋关节评分和骨折愈合率方面无统计学差异(P>0.05)。
本研究表明,TiRobot 辅助手术具有住院时间短、安全性高、微创、钉放置成功率高、可减少术中辐射和股骨头坏死发生率等优点,可获得满意的临床效果,值得临床推广。