Fixation with percutaneous cannulated screws assisted by robot navigation for femoral neck fractures

Objective To discuss clinical efficacy of fixation with percutaneous cannulated screws assisted by robot navigation for femoral neck fractures. Methods From October 2012 to June 2014, 21 patients with femoral neck fracture were treated by internal fixation with percutaneous cannulated screws assisted by robot navigation. They were 8 men and 13 women, 20 to 85 years of age (average, 65.2±4.2 years). By the Garden classification, 2 cases were type I, 5 type Ⅱ, 9 type Ⅲ and 5 type Ⅳ. The other 25 similar patients who had undergone at the same time conventional surgery with manual positioning were selected as a control group. The 2 groups were compared in terms of operation time, fluoroscopy frequency, intraoperative bleeding, total drilling, fracture healing time and Harris scores at the last follow-up. Results The robot navigation group needed insignificantly shorter operation time (75.2±10.6 minutes versus 85.1±11.3 minutes) and fracture healing time (5.3±2.5 months versus 6.1±3.0 months) than the control group (P > 0.05). The robot navigation group incurred significantly less fluoroscopy frequency (28.5±9.8 times versus 48.6±8.1 times), intraoperative bleeding (9.4±7.6 mL versus 40.2±10.3 mL), and total drilling (9.2±4.5 times versus 17.5±8.5 times) than the control group (P 0.05). No such complications were found in all patients as infection, fixation loosening, fragment re-displacement and femoral head necrosis. Conclusion In the treatment of femoral neck fractures, fixation with percutaneous cannulated screws assisted with robot navigation is advantageous over conventional surgery with manual positioning, because the former leads to easier manipulation, more accurate screw insertion, less invasion and less radiation exposure. Key words: Femoral neck fracture; Fracture fixation, internal; Robotics; Surgery, computerassisted