Original Clinical Article
Preliminary application of the intelligent robot-assisted fracture reduction system in pelvic fractures
Cao Qiyong, Zhao Chunpeng, Bei Mingjian, Xiao Honghu, Chen Yimin, Sun Xu, Li Yuneng, Wu Xinbao
Published 2023-10-01
Cite as Chin J Orthop, 2023, 43(19): 1293-1299. DOI: 10.3760/cma.j.cn121113-20230506-00271
Abstract
ObjectiveTo elucidate the recent therapeutic efficacy of the intelligent fracture reduction robotic system in managing pelvic fractures.
MethodsA retrospective evaluation of 49 pelvic fracture patients treated using the intelligent fracture reduction robotic system at Beijing Jishuitan Hospital's trauma orthopedics department between March 2021 and December 2022 was conducted. The cohort included 30 males and 19 females, with a mean age of 51.51±18.71 years (20-92 years range). Fractures were classified according to the Tile system: B1 type in 2 cases, B2 in 7, B3 in 3, C1 in 30, and C2 in 3. The median interval between injury and surgery was 6 days, with a range of 2-22 days. The robotic system assisted in pelvic fracture reduction and stabilization surgeries. Preoperative and postoperative evaluations involved pelvic CT scans, anteroposterior, inlet, and outlet radiographic images. Fracture displacement and reduction outcomes were assessed via X-ray imagery. Data captured included intraoperative blood loss, duration of surgery, fracture stabilization techniques, and postoperative monitoring period. The Majeed scoring system gauged functional outcomes.
ResultsOf the patients, 48 underwent minimally invasive interventions with robotic assistance, while one case necessitated open reduction and internal fixation due to an unsuccessful reduction. The duration between injury and operation ranged from 2 to 22 days. Average surgical time stood at 206.5±7.1 minutes (105-440 min range), and median intraoperative blood loss was 100ml (10-600 ml range). Using the Matta reduction criteria, 30 postoperative cases exhibited excellent and 9 good outcomes for posterior pelvic ring displacement, translating to a 93% (38/41) positive rate. For anterior pelvic ring shifts, 45 showed excellent and 3 good outcomes, culminating in a 100% (48/48) success rate. Follow-up for the 48 cases lasted 11.0 months (3-23 months range), with the Majeed functional score averaging 81.9±17.0 points (42-100 point range). 27 cases scored excellent, and 11 good, yielding a combined positive outcome rate of 79.2% (38/48).
ConclusionEmploying the intelligent fracture reduction robotic system in pelvic fracture treatments facilitates minimally invasive interventions and yields favorable short-term clinical results.
Key words:
Pelvis; Fracture fixation; Robotic surgical procedures; Minimally invasive surgical procedures; Treatment outcome
Contributor Information
Cao Qiyong
Department of Orthopaedics and Traumatology, Beijing Jishuitan Hospital, Beijing 100035, China
Zhao Chunpeng
Department of Orthopaedics and Traumatology, Beijing Jishuitan Hospital, Beijing 100035, China
Bei Mingjian
Department of Orthopaedics and Traumatology, Beijing Jishuitan Hospital, Beijing 100035, China
Xiao Honghu
Department of Orthopaedics and Traumatology, Beijing Jishuitan Hospital, Beijing 100035, China
Chen Yimin
Department of Orthopaedics and Traumatology, Beijing Jishuitan Hospital, Beijing 100035, China
Sun Xu
Department of Orthopaedics and Traumatology, Beijing Jishuitan Hospital, Beijing 100035, China
Li Yuneng
Department of Orthopaedics and Traumatology, Beijing Jishuitan Hospital, Beijing 100035, China
Wu Xinbao
Department of Orthopaedics and Traumatology, Beijing Jishuitan Hospital, Beijing 100035, China