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Robot‐assisted Percutaneous Cannulated Screw Fixation of Femoral Neck Fractures: Preliminary Clinical Results

OBJECTIVE: To assess the clinical efficacy of TiRobot‐assisted percutaneous cannulated screw fixation in the treatment of femoral neck fractures. METHODS: From September 2015 to July 2017, 26 patients with unilateral femoral neck fractures were treated with TiRobot‐assisted percutaneous cannulated s...

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Autores principales: Duan, Sheng‐jun, Liu, Hua‐shui, Wu, Wen‐cheng, Yang, Kun, Zhang, Zhen, Liu, Shi‐dong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons Australia, Ltd 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6430447/
https://www.ncbi.nlm.nih.gov/pubmed/30834705
http://dx.doi.org/10.1111/os.12430
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author Duan, Sheng‐jun
Liu, Hua‐shui
Wu, Wen‐cheng
Yang, Kun
Zhang, Zhen
Liu, Shi‐dong
author_facet Duan, Sheng‐jun
Liu, Hua‐shui
Wu, Wen‐cheng
Yang, Kun
Zhang, Zhen
Liu, Shi‐dong
author_sort Duan, Sheng‐jun
collection PubMed
description OBJECTIVE: To assess the clinical efficacy of TiRobot‐assisted percutaneous cannulated screw fixation in the treatment of femoral neck fractures. METHODS: From September 2015 to July 2017, 26 patients with unilateral femoral neck fractures were treated with TiRobot‐assisted percutaneous cannulated screw fixation. The femoral necks were fixed using three cannulated screws with robot assistance applying the following procedure: image acquisition, path planning, and needle and screw placement. The results of the treatment, including operation duration, frequency of fluoroscopy use, implant placement accuracy, intraoperative bleeding, total drilling, surgical complications, fracture healing time, fracture healing rate, and Harris scores at the last follow‐up, were recorded and compared with 23 similar patients who underwent conventional manual positioning surgery. RESULTS: A total of 147 cannulated screws were placed in all patients. The TiRobot group had shorter operation duration (62.6 ± 8.7 min vs 72.4 ± 10.3 min) and fracture healing time (5.1 ± 2.4 months vs 5.9 ± 2.8 months) than the conventional group (P > 0.05). The robot group had significantly less use of fluoroscopy (26.5 ± 7.4 times vs 51.3 ± 9.4 times), intraoperative bleeding (8.2 ± 5.3 mL vs 36.4 ± 12.5 mL), and total drilling (9.4 ± 4.2 times vs 18.3 ± 9.1 times) than the conventional group (all P < 0.05). The screw parallelism was significantly improved (24.0 ± 0.6 points vs 21.5 ± 1.2 points) and the neck‐width coverage (72.0 ± 6.7 mm(2) vs 53.8 ± 10.4 mm(2)) was significantly enlarged compared to the conventional group (P < 0.05). Only three guiding needles were used to penetrate the femoral head during manual insertion in the TiRobot group, which was significantly lower than that in the conventional group (3/78, 3.8% vs 9/69, 13.0%; P < 0.05). Other complications such as wound infection, vascular or nerve injury, screw loosening, and secondary screw displacement, did not occur in the two groups. There was no significant difference between the two groups in fracture healing rate (88.4% vs 82.6%) and Harris scores at the last follow up (88.2 ± 3.6 points vs 87.3 ± 4.7 points; P > 0.05). CONCLUSION: TiRobot‐assisted percutaneous cannulated screw fixation of femoral neck fractures is advantageous over conventional surgery with manual positioning due to easier manipulation, more accurate screw insertion, less invasion, and less radiation exposure, suggesting that it is a better method to stabilize femoral neck fractures.
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spelling pubmed-64304472019-09-10 Robot‐assisted Percutaneous Cannulated Screw Fixation of Femoral Neck Fractures: Preliminary Clinical Results Duan, Sheng‐jun Liu, Hua‐shui Wu, Wen‐cheng Yang, Kun Zhang, Zhen Liu, Shi‐dong Orthop Surg Clinical Articles OBJECTIVE: To assess the clinical efficacy of TiRobot‐assisted percutaneous cannulated screw fixation in the treatment of femoral neck fractures. METHODS: From September 2015 to July 2017, 26 patients with unilateral femoral neck fractures were treated with TiRobot‐assisted percutaneous cannulated screw fixation. The femoral necks were fixed using three cannulated screws with robot assistance applying the following procedure: image acquisition, path planning, and needle and screw placement. The results of the treatment, including operation duration, frequency of fluoroscopy use, implant placement accuracy, intraoperative bleeding, total drilling, surgical complications, fracture healing time, fracture healing rate, and Harris scores at the last follow‐up, were recorded and compared with 23 similar patients who underwent conventional manual positioning surgery. RESULTS: A total of 147 cannulated screws were placed in all patients. The TiRobot group had shorter operation duration (62.6 ± 8.7 min vs 72.4 ± 10.3 min) and fracture healing time (5.1 ± 2.4 months vs 5.9 ± 2.8 months) than the conventional group (P > 0.05). The robot group had significantly less use of fluoroscopy (26.5 ± 7.4 times vs 51.3 ± 9.4 times), intraoperative bleeding (8.2 ± 5.3 mL vs 36.4 ± 12.5 mL), and total drilling (9.4 ± 4.2 times vs 18.3 ± 9.1 times) than the conventional group (all P < 0.05). The screw parallelism was significantly improved (24.0 ± 0.6 points vs 21.5 ± 1.2 points) and the neck‐width coverage (72.0 ± 6.7 mm(2) vs 53.8 ± 10.4 mm(2)) was significantly enlarged compared to the conventional group (P < 0.05). Only three guiding needles were used to penetrate the femoral head during manual insertion in the TiRobot group, which was significantly lower than that in the conventional group (3/78, 3.8% vs 9/69, 13.0%; P < 0.05). Other complications such as wound infection, vascular or nerve injury, screw loosening, and secondary screw displacement, did not occur in the two groups. There was no significant difference between the two groups in fracture healing rate (88.4% vs 82.6%) and Harris scores at the last follow up (88.2 ± 3.6 points vs 87.3 ± 4.7 points; P > 0.05). CONCLUSION: TiRobot‐assisted percutaneous cannulated screw fixation of femoral neck fractures is advantageous over conventional surgery with manual positioning due to easier manipulation, more accurate screw insertion, less invasion, and less radiation exposure, suggesting that it is a better method to stabilize femoral neck fractures. John Wiley & Sons Australia, Ltd 2019-03-04 /pmc/articles/PMC6430447/ /pubmed/30834705 http://dx.doi.org/10.1111/os.12430 Text en © 2019 The Authors. Orthopaedic Surgery published by Chinese Orthopaedic Association and John Wiley & Sons Australia, Ltd This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Articles
Duan, Sheng‐jun
Liu, Hua‐shui
Wu, Wen‐cheng
Yang, Kun
Zhang, Zhen
Liu, Shi‐dong
Robot‐assisted Percutaneous Cannulated Screw Fixation of Femoral Neck Fractures: Preliminary Clinical Results
title Robot‐assisted Percutaneous Cannulated Screw Fixation of Femoral Neck Fractures: Preliminary Clinical Results
title_full Robot‐assisted Percutaneous Cannulated Screw Fixation of Femoral Neck Fractures: Preliminary Clinical Results
title_fullStr Robot‐assisted Percutaneous Cannulated Screw Fixation of Femoral Neck Fractures: Preliminary Clinical Results
title_full_unstemmed Robot‐assisted Percutaneous Cannulated Screw Fixation of Femoral Neck Fractures: Preliminary Clinical Results
title_short Robot‐assisted Percutaneous Cannulated Screw Fixation of Femoral Neck Fractures: Preliminary Clinical Results
title_sort robot‐assisted percutaneous cannulated screw fixation of femoral neck fractures: preliminary clinical results
topic Clinical Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6430447/
https://www.ncbi.nlm.nih.gov/pubmed/30834705
http://dx.doi.org/10.1111/os.12430
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