Objective To investigate the effectiveness of Holosight robotic navigation-assisted percutaneous cannulated screw fixation for femoral neck fractures. Methods A retrospective analysis was conducted on 65 patients with femoral neck fractures treated with cannulated screw fixation between January 2022 and February 2024. Among them, 31 patients underwent robotic navigation-assisted screw placement (navigation group), while 34 underwent conventional freehand percutaneous screw fixation (freehand group). Baseline characteristics, including age, gender, fracture side, injury mechanism, Garden classification, Pauwels classification, and time from injury to operation, showed no significant differences between the two groups (P>0.05). The operation time, intraoperative blood loss, fluoroscopy frequency, fracture healing time, and complications were recorded and compared, and hip function was evaluated by Harris score at last follow-up. Postoperative anteroposterior and lateral hip X-ray films were taken to assess screw distribution accuracy, including deviation from the femoral neck axis, inter-screw parallelism, and distance from screws to the femoral neck cortex. Results No significant difference was observed in operation time between the two groups (P>0.05). However, the navigation group demonstrated superior outcomes in intraoperative blood loss, fluoroscopy frequency, deviation from the femoral neck axis, inter-screw parallelism, and distance from screws to the femoral neck cortex (P<0.05). No incision infections or deep vein thrombosis occurred. All patients were followed up 12-18 months (mean, 16 months). In the freehand group, 1 case suffered from cannulated screw dislodgement and nonunion secondary to osteonecrosis of femoral head at 1 year after operation, 1 case suffered from screw penetration secondary to osteonecrosis of femoral head at 5 months after operation; and 1 case suffered from nonunion secondary to osteonecrosis of femoral head at 6 months after operation in the navigation group. All the 3 patients underwent internal fixators removal and total hip arthroplasty. There was no significant difference in the incidence of complications between the two groups (P>0.05). The fracture healing time and hip Harris score at last follow-up in the navigation group were significantly better than those in the freehand group (P<0.05). ConclusionCompared to freehand percutaneous screw fixation, Holosight robotic navigation-assisted cannulated screw fixation for femoral neck fractures achieves higher precision, reduced intraoperative radiation exposure, smaller incisions, and superior postoperative hip function recovery.
ObjectiveTo compare the effectiveness of Holosight robot-assisted percutaneous reduction and internal fixation versus reduction and internal fixation via sinus tarsi approach in treatment of calcaneal fractures. MethodsA retrospective analysis was conducted on 46 cases (46 feet) of closed intra-articular calcaneal fractures classified as Sanders type Ⅱ or Ⅲ, admitted between June 2022 and June 2025. Among them, 20 patients were treated with Holosight robot-assisted percutaneous reduction and internal fixation (RA group), and 26 with open reduction and internal fixation via sinus tarsi approach (control group). There was no significant difference between groups (P>0.05) in age, gender, affected side, fracture classification, the interval between fracture and operation, and preoperative visual analogue scale (VAS) score for pain, American Orthopedic Foot and Ankle Association (AOFAS) score, calcaneal morphological parameters (length, width, height, B?hler angle, Gissane angle). The two groups were compared in terms of operation time, intraoperative blood loss, fluoroscopy frequency, screw (guide wire) adjustment times, initial screw (guide wire) implantation success rate, incidence of complications, and the differences in calcaneal morphological parameters, pain and functional outcomes (VAS and AOFAS scores) between pre- and post-operation. ResultsCompared with the control group, the RA group had significantly less intraoperative blood loss, fewer fluoroscopy frequency, fewer screw (guide wire) adjustments, higher initial screw (guide wire) implantation success rate, and shorter operation time and hospital stay (P<0.05). No postoperative complication occurred in RA group, whereas 1 case of superficial incision infection was observed in control group; however, there was no significant difference in the incidence of complications between groups (P>0.05). All patients were followed up 6-7 months (mean, 6.5 months). X-ray film at last follow-up showed that all fractures healed. At 6 months after operation, the calcaneal morphological parameters and pain and functional indicators all significantly improved when compared with the preoperative values in the two groups (P<0.05). The changes in VAS score and AOFAS score differed significantly between the two groups (P<0.05), whereas no significant difference was found in the changes of the other indicators (P>0.05). ConclusionCompared with the operation via sinus tarsi approach, Holosight robot-assisted percutaneous reduction and internal fixation for calcaneal fractures demonstrates superior safety and effectiveness, as evidenced by shortened operation and hospital stay, reduced intraoperative blood loss and the fluoroscopy frequency, improved screw placement accuracy, enhanced postoperative functional recovery.
