Objective: To investigate the short-term effectiveness and advantages of the orthopedic robot-assisted femoral neck system (FNS) fixation in the treatment of fresh femoral neck fractures compared with the traditional manual operation.
Methods: A clinical data of 74 patients with fresh femoral neck fractures, who had undergone internal fixation with FNS between April 2020 and September 2021, was retrospectively analyzed. Among them, there were 31 cases of TiRobot-assisted operation (trial group) and 43 cases of traditional manual operation (control group). There was no significant difference between groups ( P>0.05) in terms of gender, age, cause of injury, time from injury to operation, fracture side and type. The fracture fixation time (intraoperative fracture reduction to the end of suture), invasive fixation time (incision of internal fixation to the end of suture), the number of placing key-guide needle, incision length, intraoperative blood loss, fracture healing, and Harris score of hip function were recorded and compared.
Results: All operations were performed with no neurovascular injury or incision complications. The invasive fixation time, intraoperative blood loss, the number of placing key-guide needle, and the incision length in the trial group were superior to the control group ( P<0.05), and there was no significant difference in fracture fixation time between groups ( P>0.05). All patients were followed up 4-16 months (mean, 7 months). The fracture did not heal in 1 patient of trial group, and the other fractures healed in 2 groups; the fracture healing time was (17.6±1.9) weeks in trial group and (18.2±1.9) weeks in control group, and there was no significant difference between groups ( t=0.957, P=0.345). At last follow-up, the Harris score of the trial group was 82.4±5.8, which was higher than that of the control group (79.0±7.7), but the difference was not significant ( t=-1.483, P=0.147).
Conclusion: Orthopedic robot-assisted FNS fixation in the treatment of fresh femoral neck fractures has the similar short-term effectiveness as the traditional method, but the former has advantages in terms of operation time, intraoperative blood loss, and the number of placing key-guide needle, making the operation more minimally invasive and quicker, and more suitable for older patients.
目的: 通过与传统徒手操作比较，探讨骨科机器人辅助股骨颈动力交叉钉系统（femoral neck system，FNS）治疗新鲜股骨颈骨折的近期疗效及优势。.
方法: 回顾分析2020年4月—2021年9月74例应用FNS治疗的新鲜股骨颈骨折患者临床资料。其中，天玑骨科机器人辅助手术（试验组）31例，传统徒手操作（对照组）43例。两组患者性别、年龄、致伤原因、受伤至手术时间、骨折侧别及分型等一般资料比较，差异均无统计学意义（ P>0.05）。记录并比较骨折固定时间（术中骨折复位后至切口缝合结束）、有创固定时间（内固定切口切开至切口缝合结束）、主导针置入次数、切口长度、术中出血量、骨折愈合情况以及髋关节功能 Harris评分。.
结果: 所有患者均顺利完成手术，无神经血管损伤及切口并发症发生。试验组有创固定时间、术中出血量、主导针置入次数以及切口长度均优于对照组（ P<0.05），骨折固定时间组间差异无统计学意义（ P>0.05）。术后两组患者均获随访，随访时间4～16个月，平均7个月。试验组1例骨折不愈合，其余患者骨折均愈合；试验组及对照组骨折愈合时间分别为（17.6±1.9）、（18.2±1.9）周，组间比较差异无统计学意义（ t=0.957， P=0.345）。末次随访时，试验组Harris评分为（82.4±5.8）分，高于对照组（79.0±7.7）分，但差异无统计学意义（ t=–1.483， P=0.147）。.
结论: 骨科机器人辅助FNS治疗新鲜股骨颈骨折近期疗效与传统徒手操作相似，但在手术时间、术中出血量以及主导针置入次数方面具有优势，使手术更微创快捷，更适用于年龄较大的患者。.
Keywords: Orthopedic robot; femoral neck fracture; femoral neck system; fresh fracture; short-term effectiveness.