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

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

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.	李寧, 劉昊楠, 龔曉峰, 等. 北京某三甲醫院股骨頸骨折住院患者現狀的流行病學分析. 北京大學學報(醫學版), 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, 張海濤. 人工雙極股骨頭置換術治療老年股骨頸骨折的療效分析. 華西醫學, 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, 劉保健, 溫孝明, 等. 閉合復位加壓空心螺釘內固定治療中青年股骨頸骨折的療效觀察. 中國骨傷, 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.	Gümü?ta? SA, Tosun HB, A??r ?, 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, 羅曉中, 吳剛, 等. 機器人導航下及傳統經皮空心拉力螺釘內固定術治療股骨頸骨折的療效比較. 中國修復重建外科雜志, 2016, 30(6): 685-689.
16.	戚浩天, 葛振新, 田維, 等. 機器人輔助雙側三角固定治療創傷性脊柱骨盆分離. 中華骨科雜志, 2021, 41(15): 1001-1009.
17.	侯海濤, 邵詩澤, 王亞楠, 等. Renaissance脊柱手術機器人在中上胸椎骨折中的應用. 中華骨科雜志, 2021, 41(12): 763-769.
18.	王軍強, 張騰, 吳新寶. 基于骨科手術機器人定位系統的精準微創內固定治療股骨頸骨折. 骨科臨床與研究雜志, 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. 李寧, 劉昊楠, 龔曉峰, 等. 北京某三甲醫院股骨頸骨折住院患者現狀的流行病學分析. 北京大學學報(醫學版), 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, 張海濤. 人工雙極股骨頭置換術治療老年股骨頸骨折的療效分析. 華西醫學, 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, 劉保健, 溫孝明, 等. 閉合復位加壓空心螺釘內固定治療中青年股骨頸骨折的療效觀察. 中國骨傷, 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. Gümü?ta? SA, Tosun HB, A??r ?, 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, 羅曉中, 吳剛, 等. 機器人導航下及傳統經皮空心拉力螺釘內固定術治療股骨頸骨折的療效比較. 中國修復重建外科雜志, 2016, 30(6): 685-689.
16. 戚浩天, 葛振新, 田維, 等. 機器人輔助雙側三角固定治療創傷性脊柱骨盆分離. 中華骨科雜志, 2021, 41(15): 1001-1009.
17. 侯海濤, 邵詩澤, 王亞楠, 等. Renaissance脊柱手術機器人在中上胸椎骨折中的應用. 中華骨科雜志, 2021, 41(12): 763-769.
18. 王軍強, 張騰, 吳新寶. 基于骨科手術機器人定位系統的精準微創內固定治療股骨頸骨折. 骨科臨床與研究雜志, 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

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content