Application of Robot Positioning for Cannulated Screw Internal Fixation in the Treatment of Femoral Neck Fracture: Retrospective Study

Abstract

Background Femoral neck fracture is a common type of hip fracture. Conventional surgical treatment aims at fixing the fracture site with screws and then gradually promoting bone healing. A robot-assisted orthopedic surgery system is computer technology applied to surgical treatment. Objective This study aimed to explore the therapeutic effect and prognostic value of percutaneous cannulated screw internal fixation using robot-assisted positioning in patients with femoral neck fractures. Methods From July 2018 to September 2019, 42 cases of femoral neck fracture admitted to the Second Affiliated Hospital of Luohe Medical College were randomly and averagely divided into control and study groups. The patients in the control group were treated with conventional percutaneous cannulated screw internal fixation, while the patients in the study group were treated with robot-assisted percutaneous cannulated screw fixation during surgical treatment. We compared the treatment conditions and results of the operation between the 2 groups. The Harris score was used to evaluate the treatment efficacy. The state of fracture healing was followed up and compared between the 2 groups. Results The duration of the operation was shorter, there was less fluoroscopy use, and there were fewer drilled holes in the study group than in the control group (all, P<.001). There was no statistical difference in the amount of intraoperative bleeding between the 2 groups (P=.33). The Harris score (P=.045) and number of excellent and good ratings (P=.01) were significantly higher in the study group than in the control group. The difference in the fracture healing rate between the 2 groups was not statistically significant (P=.23). The fracture healing duration of the study group was shorter than that of the control group (P=.001). Conclusions The use of robotic positioning aids in the treatment of femoral neck fractures with percutaneous cannulated screw fixation can effectively improve the efficiency of surgery, shorten the duration of surgery, and reduce the radiation damage to patients. Meanwhile, it improves postoperative treatment and recovery rates of the patients and shortens the fracture healing time.

Robot-Assisted Versus Conventional Freehand Fluoroscopy-Guided Percutaneous Screw Fixation in Femoral Neck Fractures: A Systematic Review and Meta-analysis

“…Tong et al (2016) [ 11 ] and Cao et al (2017) [ 12 ] were the first two studies to look at robot-assisted femoral neck fixation. All studies except for Duan et al (2019) [ 13 ], He et al (2019) [ 14 ], and Wan et al (2021) [ 15 ], which were prospective studies, were retrospective cohort studies. Duan et al [ 13 ] was a prospective cohort study, while He et al [ 14 ] and Wan et al [ 15 ] were the only randomized control trials.…”

“…All studies except for Duan et al (2019) [ 13 ], He et al (2019) [ 14 ], and Wan et al (2021) [ 15 ], which were prospective studies, were retrospective cohort studies. Duan et al [ 13 ] was a prospective cohort study, while He et al [ 14 ] and Wan et al [ 15 ] were the only randomized control trials. Wang et al (2019) [ 16 ] and Zhu et al (2021) [ 17 ] were the largest studies with 128 and 133 patients each compared to the other studies that had a number of included patients in the range of 3-60.…”

“…Screw fixation loosening has been reported in all studies. In He et al [ 14 ], Wang et al [ 16 ], and Wan et al [ 15 ], the conventional treatment is linked with a greater likelihood of screw fixation loosening. No significant differences were seen between the groups in other studies.…”

“…Overall, both studies have a low risk of bias in most areas; however, due to a lack of information in the study methodologies, selection bias and performance bias were rated as unclear for both groups. Detection bias was also unclear for Wan et al [ 15 ].…”

Clinical observation and finite element analysis of cannulated screw internal fixation in the treatment of femoral neck fracture based on different reduction quality

“…With the increasing aging of the population, the incidence of femoral neck fractures is increasing year by year [ 2 , 3 ]. Moreover, due to the rapid development of social economy, high-energy injuries caused by car accidents and falls from height are increasing, and the incidence of femoral neck fractures in young and middle-aged people is increasing year by year [ 4 ]. Young and middle-aged patients require joint function activities, so it is necessary to maintain the shape and function of the original joint through reduction as much as possible [ 5 , 6 ].…”