Objective: To investigate the early effectiveness of the Ti-Robot assisted femoral neck system (FNS) in the treatment of elderly Garden type Ⅱ and Ⅲ femoral neck fractures.
Methods: A retrospective analysis was conducted on the clinical data of 41 elderly patients with Garden type Ⅱ and Ⅲ femoral neck fractures who were admitted between December 2019 and August 2022 and met the selection criteria. Among them, 21 cases were treated with Ti-Robot assisted FNS internal fixation (study group), and 20 cases were treated solely with FNS internal fixation (control group). There was no significant difference in baseline data, including gender, age, side, cause of injury, time from injury to surgery, fracture Garden classification, and fracture line classification, between the two groups ( P>0.05). Surgical effectiveness was evaluated based on parameters such as operation time (including incision time and total operation time), reduction level, number of dominant pin insertions, intraoperative fluoroscopy frequency, incision length, whether to extend the incision, need for assisted reduction, postoperative hospital stay, fracture healing time, incidence of osteonecrosis of the femoral head, postoperative visual analogue scale (VAS) score at 1 day, and Harris hip score at last follow-up.
Results: The study group showed significantly shorter incision time, fewer dominant pin insertions, fewer instances of extended incisions, fewer intraoperative fluoroscopy frequency, and smaller incisions than the control group ( P<0.05). There was no significant difference in total operation time, reduction level, and assisted reduction frequency between the two groups ( P>0.05). Both groups achieved primary wound healing postoperatively, with no complications such as incision leakage or skin infection. All patients were followed up 12-24 months with an average of 14.6 months. Fractures healed in both groups, with no significant difference in healing time ( P>0.05). There was no significant difference in postoperative hospital stay between the two groups ( P>0.05). The study group showed significantly better VAS score at 1 day after operation and Harris hip score at last follow-up when compared to the control group ( P<0.05). No complication such as internal fixation failure, fracture displacement, or hip joint varus occurred in both groups during the follow-up. Osteonecrosis of the femoral head occurred in 1 patient of the control group, while no was observed in the study group, and the difference in the incidence of osteonecrosis of the femoral head between the two groups was not significant ( P=0.488).
Conclusion: Compared to sole FNS internal fixation treatment, Ti-Robot assisted FNS internal fixation for elderly Garden typeⅡ and Ⅲ femoral neck fractures can reduce incision time, achieve minimally invasive and accurate nail implantation, and decrease intraoperative fluoroscopy frequency, leading to improved postoperative hip joint function recovery.
目的: 探讨天玑骨科机器人辅助股骨颈动力交叉钉系统（femoral neck system，FNS）治疗老年Garden Ⅱ、Ⅲ型股骨颈骨折的早期临床疗效。.
方法: 回顾分析2019年12月—2022年8月收治且符合选择标准的41例老年Garden Ⅱ、Ⅲ型股骨颈骨折患者临床资料，其中21例采用天玑骨科机器人辅助FNS内固定治疗（研究组），20例采用单纯FNS内固定治疗（对照组）。两组患者性别、年龄、侧别、致伤原因、受伤至手术时间、骨折Garden分型、骨折线分型等基线资料比较差异均无统计学意义（ P>0.05）。记录手术时间（包括有创手术时间、总手术时间）、骨折复位等级、主导针进针次数、术中透视次数、切口长度、是否延长切口、是否辅助复位、术后住院时间、骨折愈合时间、是否发生股骨头坏死、术后1 d疼痛视觉模拟评分（VAS）、末次随访髋关节Harris评分等指标评价手术疗效。.
结果: 研究组有创手术时间、主导针进针次数、延长切口例数、术中透视次数、切口长度均明显少于对照组，差异有统计学意义（ P<0.05）；两组总手术时间、骨折复位等级及辅助复位例数比较差异均无统计学意义（ P>0.05）。两组患者术后切口均Ⅰ期愈合，无切口渗液、皮肤感染等并发症发生。所有患者均获随访，随访时间12～24个月，平均14.6个月。两组患者骨折均愈合，愈合时间比较差异无统计学意义（ P>0.05）。两组术后住院时间比较差异无统计学意义（ P>0.05）；研究组术后1 d VAS评分及末次随访Harris评分均明显优于对照组（ P<0.05）。两组随访期间均未发生内固定失败、骨折移位、髋关节内翻等并发症。对照组1例发生股骨头坏死，研究组无股骨头坏死发生，两组股骨头坏死发生率比较差异无统计学意义（ P=0.488）。.
结论: 与单纯FNS内固定治疗比较，天玑骨科机器人辅助FNS内固定治疗老年Garden Ⅱ、Ⅲ型股骨颈骨折，能够缩短有创手术时间，微创、准确植钉并减少术中透视次数，术后髋关节功能恢复更佳。.
Keywords: Femoral neck fracture; Ti-Robot; femoral neck system; the elderly.