WANG Zhaodong , LIU Yajun , XU Chen , DUAN Keyou , ZHU Zhonglian , WU Min , GUAN Jianzhong
  • Department of Orthopaedics, the First Affiliated Hospital of Bengbu Medical University, Anhui Key Laboratory of Tissue Transplantation, Bengbu Anhui, 233004, P. R. China;
GUAN Jianzhong, Email: guanjianzhong@bbmc.edu.cn
Femoral neck fracture; robot-guided surgery; femoral neck system; cannulate compression screw; short-term effectiveness
10.7507/1002-1892.202406075
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Objective  To investigate short-term effectiveness of robot-guided femoral neck system combined with cannulate compression screw (CCS) fixation in treatment of femoral neck fracture in young and middle-aged patients. Methods  A clinical data of 49 young and middle-aged patients with femoral neck fractures, who met the selection criteria and admitted between January 2021 and June 2023, was retrospectively analyzed. After reduction of femoral neck fractures, 27 cases were treated with robot-guided FNS fixation (FNS group) and 22 cases with robot-guided FNS and CCS fixation (FNS+CCS group). There was no significant difference in baseline data such as gender, age, cause of fracture, time from fracture to operation, fracture side and classification (Garden classification and Pauwels classification) between the two groups (P>0.05). The operation time, intraoperative blood loss and fluoroscopy times, the time when the patient began bearing weight, and hip joint pain and functional scores (VAS score and Harris score) at last follow-up for two groups were recorded. Imaging re-examination was taken to evaluate the quality of fracture reduction, fracture healing, as well as the occurrence of fracture non-union, osteonecrosis of the femoral head, and femoral neck shortening. Results  All operations were successfully completed and the incisions healed by first intention. There was no significant difference in operation time and intraoperative blood loss between the two groups (P>0.05), and the intraoperative fluoroscopy frequency in FNS+CCS group significantly increased compared to FNS group (P<0.05). All patients were followed up 12-18 months (mean, 14.1 months). Imaging re-examination showed that there was no significant difference in fracture reduction quality between the two groups (P>0.05), but the fracture healing time was significantly shorter in FNS+CCS group than in FNS group (P<0.05). At last follow-up, the incidences of femoral neck shortening, fracture non-union, and osteonecrosis of femoral head were significantly lower in FNS+CCS group than in FNS group (P<0.05). There was no significant difference in VAS scores between the two groups (P>0.05). However, the Harris score was significantly higher in FNS+CCS group than in FNS group (P<0.05). Conclusion Compared with FNS fixation alone, robot-guided FNS combined with CCS fixation in the treatment of femoral neck fractures in young and middle-aged patients has obvious advantages in terms of early weight bearing and fracture healing time, improves fracture healing rate, effectively prevents postoperative complications, and can obtain better short-term effectiveness.