Safety and costs analysis of orthopedic robot-assisted treatment of calcaneal fractures based on propensity score matching_West China Medical Journal

Authors：

CAO Jing ¹ , XIA Jinghua ¹ , ZHAO Dan ¹ , WANG Chao ² , WANG Junqiang ³ , PENG Guiling ⁴ , JIA Yunyang ⁴ ,  LU Xuemei ¹

1. Nursing Department, Beijing Jishuitan Hospital, Beijing 100035, P. R. China;
2. Department of Molecular Orthopaedics, Beijing Research Institute of Traumatology and Orthopaedics, Beijing 100035, P. R. China;
3. Intelligence Orthopedics Clinical Research Ward, Beijing Jishuitan Hospital, Beijing 100035, P. R. China;
4. Department of Orthopedic Trauma, Beijing Jishuitan Hospital, Beijing 100035, P. R. China;

Corresponding author：

LU Xuemei, Email: lxm1236@sina.com

Keywords：

Orthopedic robot; calcaneal fracture; propensity score matching

DOI：

10.7507/1002-0179.202207155

Video：

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Objective To explore the safety and costs of orthopedic robot-assisted treatment of calcaneal fractures. Methods The data of patients with calcaneal fractures treated by surgery in Beijing Jishuitan Hospital between January 2021 and July 2022 were retrospectively analyzed. Propensity score matching was used to match 1∶4 patients with orthopedic robotic-assisted closed reduction and internal fixation of calcaneal fractures (orthopedic robotic group) and traditional open reduction and internal fixation surgery (traditional surgery group). The safety and costs were compared between the two groups after matching. Results A total of 253 patients were included and divided into orthopedic robotic group (11 cases) and traditional surgery group (242 cases) according to different surgical methods. Before propensity score matching, there was no significant difference in age, gender, diagnosis and comorbidities between the two groups (P>0.05). After propensity score matching, there were 11 patients in the orthopedic robotic group and 44 patients in the traditional surgery group. There was no significant difference in age, gender, diagnosis and comorbidities between the two groups (P>0.05). There was no significant difference in height, weight, body mass index, operation duration, average postoperative pain score, and highest postoperative pain score between the two groups (P>0.05). The intraoperative blood loss [10.0 (10.0, 20.0) vs. 20.0 (20.0, 50.0) mL], total length of hospital stay [(4.5±1.3) vs. (8.7±3.7) d], and postoperative length of hospital stay [(2.3±1.1) vs. (4.5±2.3) d] in the orthopedic robotic group were less than the traditional surgery group (P<0.05). There was no significant difference in the total hospitalization costs, rehabilitation costs, inspection and examination costs between the two groups (P>0.05). The surgical cost of orthopedic robot group [1413.7 (1287.7, 1790.8) vs. 2331.2 (2195.1, 2548.6) yuan], total ward cost [(3154.5±1213.7) vs. (5711.9±2147.4) yuan], ward consumables cost [(1407.0±942.0) vs. (2409.4±1458.2) yuan], ward medication costs [(257.1±146.6) vs. (846.7±525.2) yuan], ward diagnosis and treatment costs [(901.6±366.6) vs. (2010.5±830.6) yuan], nursing care costs [(159.6±46.1) vs. (345.2±174.7) yuan], total postoperative costs [(2370.4±1324.0) vs. (3888.6±1554.9) yuan], postoperative care costs [(105.4±52.2) vs. ( 205.6±128.2) yuan] were lower than the traditional surgery group (P<0.05). Conclusion Orthopedic robot-assisted treatment of calcaneal fractures can effectively reduce intraoperative blood loss, shorten hospitalization time, and have good safety. At the same time, it can reduce operating costs, total ward costs, ward medication costs and nursing costs.

Citation： CAO Jing, XIA Jinghua, ZHAO Dan, WANG Chao, WANG Junqiang, PENG Guiling, JIA Yunyang, LU Xuemei. Safety and costs analysis of orthopedic robot-assisted treatment of calcaneal fractures based on propensity score matching. West China Medical Journal, 2022, 37(10): 1476-1480. doi: 10.7507/1002-0179.202207155 Copy

1.	Tomesen T, Biert J, Frölke JP. Treatment of displaced intra-articular calcaneal fractures with closed reduction and percutaneous screw fixation. J Bone Joint Surg Am, 2011, 93(10): 920-928.
2.	Palmersheim K, Hines B, Olsen BL. Calcaneal fractures: update on current treatments. Clin Podiatr Med Surg, 2012, 29(2): 205-220.
3.	王海立, 苏艳玲, 杨宗酉, 等. 2003 年至 2012 年河北医科大学第三医院成人跟骨骨折的流行病学分析. 中华创伤骨科杂志, 2014, 16(5): 406-409.
4.	Wu Z, Su Y, Chen W, et al. Functional outcome of displaced intra-articular calcaneal fractures: a comparison between open reduction/internal fixation and a minimally invasive approach featured an anatomical plate and compression bolts. J Trauma Acute Care Surg, 2012, 73(3): 743-751.
5.	孟洪宇. 跟骨形态学分析及跟骨骨折围手术期并发症的危险因素研究. 石家庄: 河北医科大学, 2021.
6.	Lee C, Brodke D, Perdue PW Jr, et al. Talus fractures: evaluation and treatment. J Am Acad Orthop Surg, 2020, 28(20): e878-e887.
7.	Backes M, Schepers T, Beerekamp MS, et al. Wound infections following open reduction and internal fixation of calcaneal fractures with an extended lateral approach. Int Orthop, 2014, 38(4): 767-773.
8.	Zhang Q, Han XG, Xu YF, et al. Robotic navigation during spine surgery. Expert Rev Med Devices, 2020, 17(1): 27-32.
9.	郑博隆, 郝定均, 林斌, 等. “天玑”骨科手术机器人辅助与徒手穿刺椎体成形术治疗上胸椎骨质疏松性椎体压缩骨折的疗效比较. 中华创伤骨科杂志, 2021, 23(1): 20-26.
10.	Liu HS, Duan SJ, Xin FZ, et al. Robot-assisted minimally-invasive internal fixation of pelvic ring injuries: a single-center experience. Orthop Surg, 2019, 11(1): 42-51.
11.	He M, Han W, Zhao CP, et al. Evaluation of a bi-planar robot navigation system for insertion of cannulated screws in femoral neck fractures. Orthop Surg, 2019, 11(3): 373-379.
12.	严广斌. 视觉模拟评分法. 中华关节外科杂志(电子版), 2014(2): 273.
13.	庄泽, 陈郁鲜, 梁堂钊, 等. 跟骨骨折内固定术后切口愈合不良影响因素分析. 中国骨与关节损伤杂志, 2018, 33(2): 206-208.
14.	Vicenti G, Carrozzo M, Solarino G, et al. Comparison of plate, calcanealplasty and external fixation in the management of calcaneal fractures. Injury, 2019, 50(Suppl 4): S39-S46.
15.	刘凯, 王红川, 蒋俊威, 等. 3D 打印辅助小切口复位内固定治疗跟骨骨折. 华西医学, 2016, 31(5): 859-862.
16.	Dhillon MS, Bali K, Prabhakar S. Controversies in calcaneus fracture management: a systematic review of the literature. Musculoskelet Surg, 2011, 95(3): 171-181.
17.	汪洋. 跟骨骨折切开复位内固定术后软组织并发症的发生与手术时机的关系. 大连: 大连医科大学, 2012.
18.	Jiao L, Li H, Liao T, et al. Impact of percutaneous poking reduction combined with minimally invasive plate internal fixation on foot function and complications of patients with Sanders type II and III calcaneal fractures. Am J Transl Res, 2021, 13(5): 5329-5335.
19.	Kline AJ, Anderson RB, Davis WH, et al. Minimally invasive technique versus an extensile lateral approach for intra-articular calcaneal fractures. Foot Ankle Int, 2013, 34(6): 773-780.
20.	吴新宝, 孙志坚. 加速康复外科在创伤骨科的推广及展望. 骨科临床与研究杂志, 2022, 7(1): 1-3.
21.	刘奎民, 姜传强, 孙涛, 等. 天矶骨科手术机器人与传统手术治疗股骨颈骨折的直接经济负担比较. 骨科临床与研究杂志, 2020, 5(3): 143-145.
22.	王永成, 刘士懂, 王超. “天玑”骨科手术机器人应用于骨盆骨折费用研究. 现代医院管理, 2018, 16(3): 35-37.

1. Tomesen T, Biert J, Frölke JP. Treatment of displaced intra-articular calcaneal fractures with closed reduction and percutaneous screw fixation. J Bone Joint Surg Am, 2011, 93(10): 920-928.
2. Palmersheim K, Hines B, Olsen BL. Calcaneal fractures: update on current treatments. Clin Podiatr Med Surg, 2012, 29(2): 205-220.
3. 王海立, 苏艳玲, 杨宗酉, 等. 2003 年至 2012 年河北医科大学第三医院成人跟骨骨折的流行病学分析. 中华创伤骨科杂志, 2014, 16(5): 406-409.
4. Wu Z, Su Y, Chen W, et al. Functional outcome of displaced intra-articular calcaneal fractures: a comparison between open reduction/internal fixation and a minimally invasive approach featured an anatomical plate and compression bolts. J Trauma Acute Care Surg, 2012, 73(3): 743-751.
5. 孟洪宇. 跟骨形态学分析及跟骨骨折围手术期并发症的危险因素研究. 石家庄: 河北医科大学, 2021.
6. Lee C, Brodke D, Perdue PW Jr, et al. Talus fractures: evaluation and treatment. J Am Acad Orthop Surg, 2020, 28(20): e878-e887.
7. Backes M, Schepers T, Beerekamp MS, et al. Wound infections following open reduction and internal fixation of calcaneal fractures with an extended lateral approach. Int Orthop, 2014, 38(4): 767-773.
8. Zhang Q, Han XG, Xu YF, et al. Robotic navigation during spine surgery. Expert Rev Med Devices, 2020, 17(1): 27-32.
9. 郑博隆, 郝定均, 林斌, 等. “天玑”骨科手术机器人辅助与徒手穿刺椎体成形术治疗上胸椎骨质疏松性椎体压缩骨折的疗效比较. 中华创伤骨科杂志, 2021, 23(1): 20-26.
10. Liu HS, Duan SJ, Xin FZ, et al. Robot-assisted minimally-invasive internal fixation of pelvic ring injuries: a single-center experience. Orthop Surg, 2019, 11(1): 42-51.
11. He M, Han W, Zhao CP, et al. Evaluation of a bi-planar robot navigation system for insertion of cannulated screws in femoral neck fractures. Orthop Surg, 2019, 11(3): 373-379.
12. 严广斌. 视觉模拟评分法. 中华关节外科杂志(电子版), 2014(2): 273.
13. 庄泽, 陈郁鲜, 梁堂钊, 等. 跟骨骨折内固定术后切口愈合不良影响因素分析. 中国骨与关节损伤杂志, 2018, 33(2): 206-208.
14. Vicenti G, Carrozzo M, Solarino G, et al. Comparison of plate, calcanealplasty and external fixation in the management of calcaneal fractures. Injury, 2019, 50(Suppl 4): S39-S46.
15. 刘凯, 王红川, 蒋俊威, 等. 3D 打印辅助小切口复位内固定治疗跟骨骨折. 华西医学, 2016, 31(5): 859-862.
16. Dhillon MS, Bali K, Prabhakar S. Controversies in calcaneus fracture management: a systematic review of the literature. Musculoskelet Surg, 2011, 95(3): 171-181.
17. 汪洋. 跟骨骨折切开复位内固定术后软组织并发症的发生与手术时机的关系. 大连: 大连医科大学, 2012.
18. Jiao L, Li H, Liao T, et al. Impact of percutaneous poking reduction combined with minimally invasive plate internal fixation on foot function and complications of patients with Sanders type II and III calcaneal fractures. Am J Transl Res, 2021, 13(5): 5329-5335.
19. Kline AJ, Anderson RB, Davis WH, et al. Minimally invasive technique versus an extensile lateral approach for intra-articular calcaneal fractures. Foot Ankle Int, 2013, 34(6): 773-780.
20. 吴新宝, 孙志坚. 加速康复外科在创伤骨科的推广及展望. 骨科临床与研究杂志, 2022, 7(1): 1-3.
21. 刘奎民, 姜传强, 孙涛, 等. 天矶骨科手术机器人与传统手术治疗股骨颈骨折的直接经济负担比较. 骨科临床与研究杂志, 2020, 5(3): 143-145.
22. 王永成, 刘士懂, 王超. “天玑”骨科手术机器人应用于骨盆骨折费用研究. 现代医院管理, 2018, 16(3): 35-37.

West China Medical Journal

Safety and costs analysis of orthopedic robot-assisted treatment of calcaneal fractures based on propensity score matching

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