Analysis of the effect of minimally invasive percutaneous internal fixation with cannulated screws assisted by orthopedic surgical robot for the treatment of femoral neck fractures in young adult
Objective To observe the effect of minimally invasive percutaneous internal fixation with cannulated screws assisted by an orthopedic surgical robot in treating femoral neck fractures in young and middle-aged patients.Methods Between May 2018 and March 2022,24 patients with femoral neck fractures who underwent hollow nail internal fixation using orthopedic robot navigation assistance were collected as the robot assisted group,while 30 patients who received traditional barehanded positioning and internal fixation during the same period were selected as the barehanded control group.Intraoperative parameters including surgical duration,intraoperative blood loss,intraoperative fluoroscopy,and number of needle positioning times,as well as hospital stay,fracture healing time,and postoperative complications were compared.Additionally,Harris score at the last follow-up were compared between the groups.The angle between the three screws and the femoral neck axis was measured based on the immediate anteroposterior and lateral radiographs post surgery.Results The intraoperative fluoroscopy frequency(15.2±3.9)times,fluoroscopy time(13.8±3.1)s,needle positioning frequency(4.7±2.1)times,and bleeding volume(30.9±14.2)ml in the robot assisted group were lower than those in the bare handed control group(40.6±11.3)times,(32.7±9.1)s,(17.4±4.9)times,and(52.1±13.6)ml,with statistically significant differences(t=10.506,9.718,11.539,5.582,P<0.05).The robot assisted group had surgery time of(73.5±11.8)minutes,hospital stay of(8.1±2.4)days,fracture healing time of(5.3±2.2)months,Harris score of last follow-up(86.5±3.7)points,and complication incidence rate of 0.0%.There was no statistically significant difference compared to the control group's(68.3±9.4)minutes,(7.6±2.8)days,(5.8±2.1)months,(87.8±4.1)points,and 3.33%(t=1.803,0.694,0.851,1.208,0.012,P>0.05).The angle between the anterior and lateral hollow screws in the robot assisted group,the angle between the hollow screw and the femoral neck axis(1.3±1.1)°,(2.2±1.2)°,(2.7±1.5)°,and(3.8±1.4)°,were lower than those in the unarmed control group(6.5±1.8)°,(5.7±2.0)°,(7.4±1.9)°,and(7.9±1.3)°.The differences were statistically significant(t=12.407,7.547,9.894,7.663,P<0.05).Conclusion Minimally invasive percutaneous internal fixation with cannulated screws assisted by robot navigation us an effective treatment for femoral neck fracture in young adult.The hollow screw positioning is accurate,can significantly reduce the need for guide pin adjustments,decreases intraoperative fluoroscopy usage,and minimizes surgical trauma.
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