Comparison of clinical effects of traditional manual and robot-assisted screw placement in the treatment of femoral neck fracture_West China Medical Journal

Authors：

GAO Bo , WU Bi , WANG Hong , JIANG Wei , YANG Ling , CHEN Xi , ZHU Zhonglun , ZHOU Qing ,  LIU Yuehong

Department of Orthopaedics, People’s Hospital of Deyang City, Deyang, Sichuan 618000, P. R. China;

Corresponding author：

LIU Yuehong, Email: liuyuehong@vip.sina.com

Keywords：

Femoral neck fracture; Cannulated screws; Orthopaedics; Surgical robot

DOI：

10.7507/1002-0179.202108140

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Objective To compare the clinical effects of traditional manual and robot-assisted implantation of cannulated screws in the treatment of femoral neck fracture. Methods The medical records of patients with femoral neck fracture in Department of Orthopaedics, People’s Hospital of Deyang City were analyzed retrospectively. The patients were divided into two groups, including the traditional manual implantation group from January to December 2018 and the robot-assisted implantation group from May 2019 to May 2020. The clinical therapeutic efficacy of the two groups were compared. Harris hip function score was used to evaluate hip function. Results A total of 85 patients were included. All patients had closed fractures. There were 45 cases in the traditional manual implantation group and 40 cases in the robot-assisted implantation group. There was no significant difference between the two groups in preoperative waiting time, operation time, hospitalization time, fracture healing time, complications within one year after operation, or Harris hip function score one year after operation (P>0.05). The placement nail time [(11.1±2.0) vs. (23.8±2.3) min; t=27.142, P<0.001], frequency of guide pin insertion [(4.7±1.2) vs. (11.4±1.7) times; t=20.640, P<0.001], frequency of intraoperative fluoroscopy [(10.8±1.7) vs. (21.0±1.8) times; t=26.990, P<0.001] and intraoperative blood loss [(8.1±2.0) vs. (12.0±1.7) mL; t=9.711, P<0.001] in the robot-assisted implantation group were less than those in the traditional manual implantation group. No wound infection or neurovascular injury was found in the two groups. Conclusion Robot-assisted implantation of cannulated screws in the treatment of femoral neck fracture has the advantages of less fluoroscopy, fewer guide pin insertion, less blood loss, more accurate screw placement than the traditional manual implantation of cannulated screws.

Citation： GAO Bo, WU Bi, WANG Hong, JIANG Wei, YANG Ling, CHEN Xi, ZHU Zhonglun, ZHOU Qing, LIU Yuehong. Comparison of clinical effects of traditional manual and robot-assisted screw placement in the treatment of femoral neck fracture. West China Medical Journal, 2021, 36(10): 1344-1348. doi: 10.7507/1002-0179.202108140 Copy

1.	Florschutz AV, Langford JR, Haidukewych GJ, et al. Femoral neck fractures: current management. J Orthop Trauma, 2015, 29(3): 121-129.
2.	李宁, 刘昊楠, 龚晓峰, 等. 北京某三甲医院股骨颈骨折住院患者现状的流行病学分析. 北京大学学报(医学版), 2016, 48(2): 292-296.
3.	Stevens JA, Rudd RA. The impact of decreasing U. S. hip fracture rates on future hip fracture estimates. Osteoporos Int, 2013, 24(10): 2725-2728.
4.	李雪寒, 王恩才, 张海涛. 人工双极股骨头置换术治疗老年股骨颈骨折的疗效分析. 华西医学, 2011, 26(8): 1156-1158.
5.	Bhandari M, Devereaux PJ, Tornetta P 3rd, et al. Operative management of displaced femoral neck fractures in elderly patients. An international survey. J Bone Joint Surg Am, 2005, 87(9): 2122-2130.
6.	Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am, 1969, 51(4): 737-755.
7.	Han SK, Song HS, Kim R, et al. Clinical results of treatment of garden type 1 and 2 femoral neck fractures in patients over 70-year old. Eur J Trauma Emerg Surg, 2016, 42(2): 191-196.
8.	Kumar MN, Belehalli P, Ramachandra P. PET/CT study of temporal variations in blood flow to the femoral head following low-energy fracture of the femoral neck. Orthopedics, 2014, 37(6): e563-e570.
9.	胡翔, 刘保健, 温孝明, 等. 闭合复位加压空心螺钉内固定治疗中青年股骨颈骨折的疗效观察. 中国骨伤, 2018, 31(2): 111-114.
10.	Zi-Sheng A, You-Shui G, Zhi-Zhen J, et al. Hemiarthroplasty vs primary total hip arthroplasty for displaced fractures of the femoral neck in the elderly: a meta-analysis. J Arthroplasty, 2012, 27(4): 583-590.
11.	Gjertsen JE, Vinje T, Engesaeter LB, et al. Internal screw fixation compared with bipolar hemiarthroplasty for treatment of displaced femoral neck fractures in elderly patients. J Bone Joint Surg Am, 2010, 92(3): 619-628.
12.	Gümüştaş SA, Tosun HB, Ağır İ, et al. Influence of number and orientation of screws on stability in the internal fixation of unstable femoral neck fractures. Acta Orthop Traumatol Turc, 2014, 48(6): 673-678.
13.	Müller MC, Belei P, Pennekamp PH, et al. Three-dimensional computer-assisted navigation for the placement of cannulated hip screws. A pilot study. Int Orthop, 2012, 36(7): 1463-1469.
14.	Selvan VT, Oakley MJ, Rangan A, et al. Optimum configuration of cannulated hip screws for the fixation of intracapsular hip fractures: a biomechanical study. Injury, 2004, 35(2): 136-141.
15.	童祎, 罗晓中, 吴刚, 等. 机器人导航下及传统经皮空心拉力螺钉内固定术治疗股骨颈骨折的疗效比较. 中国修复重建外科杂志, 2016, 30(6): 685-689.
16.	戚浩天, 葛振新, 田维, 等. 机器人辅助双侧三角固定治疗创伤性脊柱骨盆分离. 中华骨科杂志, 2021, 41(15): 1001-1009.
17.	侯海涛, 邵诗泽, 王亚楠, 等. Renaissance脊柱手术机器人在中上胸椎骨折中的应用. 中华骨科杂志, 2021, 41(12): 763-769.
18.	王军强, 张腾, 吴新宝. 基于骨科手术机器人定位系统的精准微创内固定治疗股骨颈骨折. 骨科临床与研究杂志, 2019, 4(1): 57-60.

1. Florschutz AV, Langford JR, Haidukewych GJ, et al. Femoral neck fractures: current management. J Orthop Trauma, 2015, 29(3): 121-129.
2. 李宁, 刘昊楠, 龚晓峰, 等. 北京某三甲医院股骨颈骨折住院患者现状的流行病学分析. 北京大学学报(医学版), 2016, 48(2): 292-296.
3. Stevens JA, Rudd RA. The impact of decreasing U. S. hip fracture rates on future hip fracture estimates. Osteoporos Int, 2013, 24(10): 2725-2728.
4. 李雪寒, 王恩才, 张海涛. 人工双极股骨头置换术治疗老年股骨颈骨折的疗效分析. 华西医学, 2011, 26(8): 1156-1158.
5. Bhandari M, Devereaux PJ, Tornetta P 3rd, et al. Operative management of displaced femoral neck fractures in elderly patients. An international survey. J Bone Joint Surg Am, 2005, 87(9): 2122-2130.
6. Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am, 1969, 51(4): 737-755.
7. Han SK, Song HS, Kim R, et al. Clinical results of treatment of garden type 1 and 2 femoral neck fractures in patients over 70-year old. Eur J Trauma Emerg Surg, 2016, 42(2): 191-196.
8. Kumar MN, Belehalli P, Ramachandra P. PET/CT study of temporal variations in blood flow to the femoral head following low-energy fracture of the femoral neck. Orthopedics, 2014, 37(6): e563-e570.
9. 胡翔, 刘保健, 温孝明, 等. 闭合复位加压空心螺钉内固定治疗中青年股骨颈骨折的疗效观察. 中国骨伤, 2018, 31(2): 111-114.
10. Zi-Sheng A, You-Shui G, Zhi-Zhen J, et al. Hemiarthroplasty vs primary total hip arthroplasty for displaced fractures of the femoral neck in the elderly: a meta-analysis. J Arthroplasty, 2012, 27(4): 583-590.
11. Gjertsen JE, Vinje T, Engesaeter LB, et al. Internal screw fixation compared with bipolar hemiarthroplasty for treatment of displaced femoral neck fractures in elderly patients. J Bone Joint Surg Am, 2010, 92(3): 619-628.
12. Gümüştaş SA, Tosun HB, Ağır İ, et al. Influence of number and orientation of screws on stability in the internal fixation of unstable femoral neck fractures. Acta Orthop Traumatol Turc, 2014, 48(6): 673-678.
13. Müller MC, Belei P, Pennekamp PH, et al. Three-dimensional computer-assisted navigation for the placement of cannulated hip screws. A pilot study. Int Orthop, 2012, 36(7): 1463-1469.
14. Selvan VT, Oakley MJ, Rangan A, et al. Optimum configuration of cannulated hip screws for the fixation of intracapsular hip fractures: a biomechanical study. Injury, 2004, 35(2): 136-141.
15. 童祎, 罗晓中, 吴刚, 等. 机器人导航下及传统经皮空心拉力螺钉内固定术治疗股骨颈骨折的疗效比较. 中国修复重建外科杂志, 2016, 30(6): 685-689.
16. 戚浩天, 葛振新, 田维, 等. 机器人辅助双侧三角固定治疗创伤性脊柱骨盆分离. 中华骨科杂志, 2021, 41(15): 1001-1009.
17. 侯海涛, 邵诗泽, 王亚楠, 等. Renaissance脊柱手术机器人在中上胸椎骨折中的应用. 中华骨科杂志, 2021, 41(12): 763-769.
18. 王军强, 张腾, 吴新宝. 基于骨科手术机器人定位系统的精准微创内固定治疗股骨颈骨折. 骨科临床与研究杂志, 2019, 4(1): 57-60.

West China Medical Journal

Comparison of clinical effects of traditional manual and robot-assisted screw placement in the treatment of femoral neck fracture

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