TiRobot-assisted Percutaneous Screw Fixation In Treatment And Analysis Of Pelvic Fractures

Background:Pelvic fractures account for about 3%of total body fractures,of which unstable fractures account for about 10%.Pelvic fracture is often caused by high energy injury,often accompanied by a large amount of blood loss,pelvic organ injury and other multiple injuries,high mortality,difficult of surgical treatment,high risk,has always been a difficult problem in the Department of Orthopedics trauma.With the understanding of minimally invasive surgery and precision treatment by orthopedic surgeons,minimally invasive and accurate treatment of pelvic fractures has become an urgent problem to be solved.In recent years,TiRobot,independently developed in China,has been gradually applied in clinical practice,providing a new idea for minimally invasive treatment of pelvic fractures.Objective:By comparing with the traditional non-robot-assisted percutaneous screw fixation in the treatment of pelvic fractures,the advantages of robot-assisted percutaneous screw fixation were studied,and the clinical efficacy of this technique in minimally invasive treatment of pelvic fractures was discussed.And to provide evidence for its further clinical application.Materials and Methods:A retrospective analysis was conducted on 41 patients with pelvic fractures treated with TiRobot assisted percutaneous screw fixation and non-robot assisted percutaneous screw fixation from January 2019 to January 2020 in the Department of Traumatic Orthopedics of the Second Hospital of Shandong University and Qilu Hospital of Shandong University.In the robot-assisted surgery group,there were 20 patients,including 12 males and 8 females,aged 23-71 years old,with an average age of 46.7 years old.There were a total of 21 patients in the non-robot-assisted surgery group,including 14 males and 7 females,aged 18-63 years old,with an average age of 45.9 years old.After surgery,the reduction of pelvic fractures was evaluated by Matta standard,the screw position was evaluated by 3D CT,and hip joint activity was evaluated by Majeed functional score.The operative time,the amount of blood loss,the number and duration of intraoperative fluoroscopy,the length of postoperative incision,the length of postoperative hospital stay and the incidence of postoperative complications were recorded.Results:1.The operative time,intraoperative blood loss,intraoperative guide needle adjustment times and intraoperative fluoroscopy times of the robot-assisted surgery group and the non-robot-assisted surgery group were analyzed by t test（P<0.05）.There were significant statistical differences between the two groups in operative time,intraoperative blood loss,intraoperative guide needle adjustment times and intraoperative fluoroscopy times.The length of surgical incision between the two groups was analyzed by t test（P>0.05）,and no significant statistical difference was found.2.The surgical incisions of the 41 patients in this study were all healed in stage I without incision infection,and no obvious nerve injury was observed after surgery.All the fractures of the patients were healed after surgery,and no fractures or loosening of internal fixators were observed.Both the robot-assisted surgery group and the nonrobot-assisted surgery group were analyzed by t-test（P>0.05）,indicating that there were no significant statistical differences in postoperative hospital stay,postoperative fracture healing time and postoperative functional score（Majeed score）between the two groups.3.In this study,a total of 69 screws were inserted in 41 patients.In the robotic surgery group,38 screws were placed in 20 patients,and the optimal rate of screw placement was 95%.In the non-robotic surgery group,31 screws were placed in 21 patients,and the optimal rate of screw placement was 54%.The excellent and good rates of screw placement in the two groups were compared by Fisher’s test（P<0.05）,indicating that there were significant differences in the excellent and good rates of screw placement between the two groups.The excellent rate of fracture reduction in the robot-assisted surgery group was 35%,and that in the non-robot-assisted group was 38%.The excellent and good rates of fracture reduction in the two groups were compared using the X^2 test（P>0.05）,that is,there was no significant statistical difference in the excellent and good rates of fracture reduction in the two groups.Conclusion:1.Compared with non-robot-assisted percutaneous screw internal fixation,TiRobot robot-assisted percutaneous screw internal fixation has obvious advantages in terms of operative time,intraoperative blood loss,intraoperative fluoroscopy,guide needle adjustment times,and excellent rate of screw placement.2.TiRobot robot-assisted percutaneous screw internal fixation is more accurate,safe and effective,providing a new way for minimally invasive treatment of pelvic fractures.