Orthopaedic robot assisted closed reduction and cannulated screw internal fixation for the treatment of femoral neck fractures
Objective: To investigate the preliminary clinical effect of closed reduction and cannulated nail internal fixation for femoral neck fracture assisted by robot navigation and positioning system.
Methods: From July 2019 to January 2020, 16 cases of femoral neck fracture （navigation group） were treated with closed reduction and internal fixation guided by robot system, including 7 males and 9 females, aged 25 to 72 years old with an average of （53.61±5.45） years old；Garden classification of fracture：3 cases of typeⅠ, 3 cases of typeⅡ, 8 cases of type Ⅲ, 2 cases of type Ⅳ. Non navigation group （control group）：20 cases of femoral neck fracture were treated with closed reduction and hollow nail internal fixation, 8 males and 12 females, aged 46 to 70 years old with an average of （55.23±4.64） years old；Garden typeⅠin 2 cases, typeⅡin 4 cases, type Ⅲ in 11 cases, type Ⅳ in 3 cases. The operation time, fluoroscopy times, guide needle drilling times, screw adjustment times, intraoperative bleeding volume and other indicators of two groups were evaluated.
Results: Both groups were followed up for 12 to 18 months with an average of （15.6±2.8） months. The fractures of both groups were healed without delayed union and nonunion. There was no significant difference in healing time between two groups（P=0.782）. There was no significant difference in Harris scores between two groups at the last follow-up（P=0.813）. There was no significant difference in operation time between two groups（P>0.05）. There were significant differences between two groups in fluoroscopy times, guide needle drilling times, hollow screw replacement times, and intraoperative bleeding volume（P<0.05）.
Conclusions: Closed reduction and hollow screw internal fixation assisted by robot navigation system for femoral neck fracture has the advantages of minimally invasive operation, precise screw placement, and reduction of X-ray radiation damage during operation.