| BACKGROUND:Femoral neck fracture are one of the most common types of fractures,mostly occur in elderly women with osteoporosis,and often require surgical treatment.Femoral neck system(FNS)is a new type of internal fixation method.The system is easy to operate and biomechanically stable.It has a good effect in the treatment of femoral neck fracture.However,the traditional bare-handed nail placement has high requirements on the operation of the operator,which is likely to cause adverse effects such as long operation time,high error rate,and large trauma.With the development of radiography and computer technology,minimally invasive internal fixation under robot navigation is more and more widely used in orthopedic surgery,which makes up for the shortage of manual operation.This article introduces the surgical method of femoral neck fracture treated with femoral neck system under the guidance of "Tianji" orthopedic surgery robot,and compares it with traditional surgery,discusses the advantages and disadvantages of robot navigation,and the application prospect of robots in femoral neck fracture.OBJECTIVE:Exploring the clinical efficacy,safety,and reliability of the femoral neck system for treating femoral neck fractures under robot navigation,providing a reference for femoral neck fracture treatment under robot navigation.METHODS:In this study,a retrospective research design was employed,and a total of 57 patients with femoral neck fractures treated with FNS in the department of trauma orthopedics of our hospital from November2019 to August 2021 were selected,including 29 males and 28 females.Based on the different surgical methods,the group of patients who underwent FNS treatment for femoral neck fractures under robot navigation was set as the experimental group(robot group),while the patients with femoral neck fractures treated with conventional manual FNS were set as the control group(artificial group).The robot group consisted of 27 patients,including 12 males and 15 females,with a mean age of 58(37,63)years,while the artificial group consisted of 30 patients,including 17 males and 13 females,with a mean age of 52(41,59)years.Compare the general baseline data,operative duration,intraoperative bleeding,number of intraoperative fluoroscopic examinations,success rate of one-time nail placement,postoperative Harris hip score,postoperative Visual Analogue Scale(VAS),fracture healing time,and incidence of postoperative complications between the two groups of patients.RESULTS:1.The robot group had an operation time of(81.0±9.2)minutes,which was slightly shorter than the artificial group’s time of(86.7±12.0)minutes.However,this difference was not statistically significant(P>0.05).The robot group had significantly lower intraoperative blood loss and fluoroscopy times,with(25.5±7.5)m L and(16.4±2.8)times respectively,compared to the artificial group,which had(37.3±11.3)m L and(20.1±3.0)times.This difference was statistically significant(P<0.05).Additionally,the VAS scores of the robot group were lower than those of the artificial group on the 1st and 3rd days after the operation(P<0.05).2.The robot group had a higher success rate for one-time nail placement compared to the artificial group.Additionally,the robot group exhibited better accuracy in nail placement than the artificial group,with statistically significant differences(P<0.05).3.Two groups of patients were followed up at 1,3,6,and 12 months after surgery.During the 1-month follow-up,the Harris hip score were evaluated.The robot group scored(55.0±1.3)points,which was superior to the artificial group’s(50.6±1.3)points,and the difference was statistically significant(P<0.05).The hip Harris score of both patient groups improved after hip surgery.However,there was no statistically significant difference in the comparison of the Harris hip score between the two groups at 3,6,and 12 months after surgery(P>0.05).4.There was no statistically significant difference(P>0.05)in the comparison of hospitalization days and fracture healing time between the robot group and the artificial group.5.The incidence of postoperative complications was not statistically different(P>0.05)between the two groups.Specifically,in the robot group,there was one case of femoral head necrosis,six cases of femoral neck shortening,and one case of nonunion fracture,while in the artificial group,there were two cases of femoral head necrosis,eight cases of femoral neck shortening,and one case of nonunion fracture.CONCLUSION:1.The application of the "Tianji" orthopedic surgery robot reduces the number of intraoperative fluoroscopy and reduces the radiation exposure of patients and medical staff.It is a safer and more effective treatment plan for femoral neck fracture.2.Robot navigation can reduce intraoperative blood loss,reduce the number of screw adjustments,and reduce the damage to patients caused by multiple screw placements.3.Robot-guided FNS surgery for femoral neck fracture has a high success rate of one-time screw placement,and it is a precise,minimally invasive,safe and effective method. |
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