Safety and costs analysis of orthopedic robot-assisted treatment of calcaneal fractures based on propensity score matching_West China Medical Journal

Authors：

CAO Jing ¹ , XIA Jinghua ¹ , ZHAO Dan ¹ , WANG Chao ² , WANG Junqiang ³ , PENG Guiling ⁴ , JIA Yunyang ⁴ ,  LU Xuemei ¹

1. Nursing Department, Beijing Jishuitan Hospital, Beijing 100035, P. R. China;
2. Department of Molecular Orthopaedics, Beijing Research Institute of Traumatology and Orthopaedics, Beijing 100035, P. R. China;
3. Intelligence Orthopedics Clinical Research Ward, Beijing Jishuitan Hospital, Beijing 100035, P. R. China;
4. Department of Orthopedic Trauma, Beijing Jishuitan Hospital, Beijing 100035, P. R. China;

Corresponding?author：

LU Xuemei, Email: lxm1236@sina.com

Keywords：

Orthopedic robot; calcaneal fracture; propensity score matching

DOI：

10.7507/1002-0179.202207155

Video：

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Objective To explore the safety and costs of orthopedic robot-assisted treatment of calcaneal fractures. Methods The data of patients with calcaneal fractures treated by surgery in Beijing Jishuitan Hospital between January 2021 and July 2022 were retrospectively analyzed. Propensity score matching was used to match 1∶4 patients with orthopedic robotic-assisted closed reduction and internal fixation of calcaneal fractures (orthopedic robotic group) and traditional open reduction and internal fixation surgery (traditional surgery group). The safety and costs were compared between the two groups after matching. Results A total of 253 patients were included and divided into orthopedic robotic group (11 cases) and traditional surgery group (242 cases) according to different surgical methods. Before propensity score matching, there was no significant difference in age, gender, diagnosis and comorbidities between the two groups (P>0.05). After propensity score matching, there were 11 patients in the orthopedic robotic group and 44 patients in the traditional surgery group. There was no significant difference in age, gender, diagnosis and comorbidities between the two groups (P>0.05). There was no significant difference in height, weight, body mass index, operation duration, average postoperative pain score, and highest postoperative pain score between the two groups (P>0.05). The intraoperative blood loss [10.0 (10.0, 20.0) vs. 20.0 (20.0, 50.0) mL], total length of hospital stay [(4.5±1.3) vs. (8.7±3.7) d], and postoperative length of hospital stay [(2.3±1.1) vs. (4.5±2.3) d] in the orthopedic robotic group were less than the traditional surgery group (P<0.05). There was no significant difference in the total hospitalization costs, rehabilitation costs, inspection and examination costs between the two groups (P>0.05). The surgical cost of orthopedic robot group [1413.7 (1287.7, 1790.8) vs. 2331.2 (2195.1, 2548.6) yuan], total ward cost [(3154.5±1213.7) vs. (5711.9±2147.4) yuan], ward consumables cost [(1407.0±942.0) vs. (2409.4±1458.2) yuan], ward medication costs [(257.1±146.6) vs. (846.7±525.2) yuan], ward diagnosis and treatment costs [(901.6±366.6) vs. (2010.5±830.6) yuan], nursing care costs [(159.6±46.1) vs. (345.2±174.7) yuan], total postoperative costs [(2370.4±1324.0) vs. (3888.6±1554.9) yuan], postoperative care costs [(105.4±52.2) vs. ( 205.6±128.2) yuan] were lower than the traditional surgery group (P<0.05). Conclusion Orthopedic robot-assisted treatment of calcaneal fractures can effectively reduce intraoperative blood loss, shorten hospitalization time, and have good safety. At the same time, it can reduce operating costs, total ward costs, ward medication costs and nursing costs.

Citation： CAO Jing, XIA Jinghua, ZHAO Dan, WANG Chao, WANG Junqiang, PENG Guiling, JIA Yunyang, LU Xuemei. Safety and costs analysis of orthopedic robot-assisted treatment of calcaneal fractures based on propensity score matching. West China Medical Journal, 2022, 37(10): 1476-1480. doi: 10.7507/1002-0179.202207155 Copy

1.	Tomesen T, Biert J, Fr?lke JP. Treatment of displaced intra-articular calcaneal fractures with closed reduction and percutaneous screw fixation. J Bone Joint Surg Am, 2011, 93(10): 920-928.
2.	Palmersheim K, Hines B, Olsen BL. Calcaneal fractures: update on current treatments. Clin Podiatr Med Surg, 2012, 29(2): 205-220.
3.	王海立, 蘇艷玲, 楊宗酉, 等. 2003 年至 2012 年河北醫科大學第三醫院成人跟骨骨折的流行病學分析. 中華創傷骨科雜志, 2014, 16(5): 406-409.
4.	Wu Z, Su Y, Chen W, et al. Functional outcome of displaced intra-articular calcaneal fractures: a comparison between open reduction/internal fixation and a minimally invasive approach featured an anatomical plate and compression bolts. J Trauma Acute Care Surg, 2012, 73(3): 743-751.
5.	孟洪宇. 跟骨形態學分析及跟骨骨折圍手術期并發癥的危險因素研究. 石家莊: 河北醫科大學, 2021.
6.	Lee C, Brodke D, Perdue PW Jr, et al. Talus fractures: evaluation and treatment. J Am Acad Orthop Surg, 2020, 28(20): e878-e887.
7.	Backes M, Schepers T, Beerekamp MS, et al. Wound infections following open reduction and internal fixation of calcaneal fractures with an extended lateral approach. Int Orthop, 2014, 38(4): 767-773.
8.	Zhang Q, Han XG, Xu YF, et al. Robotic navigation during spine surgery. Expert Rev Med Devices, 2020, 17(1): 27-32.
9.	鄭博隆, 郝定均, 林斌, 等. “天璣”骨科手術機器人輔助與徒手穿刺椎體成形術治療上胸椎骨質疏松性椎體壓縮骨折的療效比較. 中華創傷骨科雜志, 2021, 23(1): 20-26.
10.	Liu HS, Duan SJ, Xin FZ, et al. Robot-assisted minimally-invasive internal fixation of pelvic ring injuries: a single-center experience. Orthop Surg, 2019, 11(1): 42-51.
11.	He M, Han W, Zhao CP, et al. Evaluation of a bi-planar robot navigation system for insertion of cannulated screws in femoral neck fractures. Orthop Surg, 2019, 11(3): 373-379.
12.	嚴廣斌. 視覺模擬評分法. 中華關節外科雜志(電子版), 2014(2): 273.
13.	莊澤, 陳郁鮮, 梁堂釗, 等. 跟骨骨折內固定術后切口愈合不良影響因素分析. 中國骨與關節損傷雜志, 2018, 33(2): 206-208.
14.	Vicenti G, Carrozzo M, Solarino G, et al. Comparison of plate, calcanealplasty and external fixation in the management of calcaneal fractures. Injury, 2019, 50(Suppl 4): S39-S46.
15.	劉凱, 王紅川, 蔣俊威, 等. 3D 打印輔助小切口復位內固定治療跟骨骨折. 華西醫學, 2016, 31(5): 859-862.
16.	Dhillon MS, Bali K, Prabhakar S. Controversies in calcaneus fracture management: a systematic review of the literature. Musculoskelet Surg, 2011, 95(3): 171-181.
17.	汪洋. 跟骨骨折切開復位內固定術后軟組織并發癥的發生與手術時機的關系. 大連: 大連醫科大學, 2012.
18.	Jiao L, Li H, Liao T, et al. Impact of percutaneous poking reduction combined with minimally invasive plate internal fixation on foot function and complications of patients with Sanders type II and III calcaneal fractures. Am J Transl Res, 2021, 13(5): 5329-5335.
19.	Kline AJ, Anderson RB, Davis WH, et al. Minimally invasive technique versus an extensile lateral approach for intra-articular calcaneal fractures. Foot Ankle Int, 2013, 34(6): 773-780.
20.	吳新寶, 孫志堅. 加速康復外科在創傷骨科的推廣及展望. 骨科臨床與研究雜志, 2022, 7(1): 1-3.
21.	劉奎民, 姜傳強, 孫濤, 等. 天磯骨科手術機器人與傳統手術治療股骨頸骨折的直接經濟負擔比較. 骨科臨床與研究雜志, 2020, 5(3): 143-145.
22.	王永成, 劉士懂, 王超. “天璣”骨科手術機器人應用于骨盆骨折費用研究. 現代醫院管理, 2018, 16(3): 35-37.

1. Tomesen T, Biert J, Fr?lke JP. Treatment of displaced intra-articular calcaneal fractures with closed reduction and percutaneous screw fixation. J Bone Joint Surg Am, 2011, 93(10): 920-928.
2. Palmersheim K, Hines B, Olsen BL. Calcaneal fractures: update on current treatments. Clin Podiatr Med Surg, 2012, 29(2): 205-220.
3. 王海立, 蘇艷玲, 楊宗酉, 等. 2003 年至 2012 年河北醫科大學第三醫院成人跟骨骨折的流行病學分析. 中華創傷骨科雜志, 2014, 16(5): 406-409.
4. Wu Z, Su Y, Chen W, et al. Functional outcome of displaced intra-articular calcaneal fractures: a comparison between open reduction/internal fixation and a minimally invasive approach featured an anatomical plate and compression bolts. J Trauma Acute Care Surg, 2012, 73(3): 743-751.
5. 孟洪宇. 跟骨形態學分析及跟骨骨折圍手術期并發癥的危險因素研究. 石家莊: 河北醫科大學, 2021.
6. Lee C, Brodke D, Perdue PW Jr, et al. Talus fractures: evaluation and treatment. J Am Acad Orthop Surg, 2020, 28(20): e878-e887.
7. Backes M, Schepers T, Beerekamp MS, et al. Wound infections following open reduction and internal fixation of calcaneal fractures with an extended lateral approach. Int Orthop, 2014, 38(4): 767-773.
8. Zhang Q, Han XG, Xu YF, et al. Robotic navigation during spine surgery. Expert Rev Med Devices, 2020, 17(1): 27-32.
9. 鄭博隆, 郝定均, 林斌, 等. “天璣”骨科手術機器人輔助與徒手穿刺椎體成形術治療上胸椎骨質疏松性椎體壓縮骨折的療效比較. 中華創傷骨科雜志, 2021, 23(1): 20-26.
10. Liu HS, Duan SJ, Xin FZ, et al. Robot-assisted minimally-invasive internal fixation of pelvic ring injuries: a single-center experience. Orthop Surg, 2019, 11(1): 42-51.
11. He M, Han W, Zhao CP, et al. Evaluation of a bi-planar robot navigation system for insertion of cannulated screws in femoral neck fractures. Orthop Surg, 2019, 11(3): 373-379.
12. 嚴廣斌. 視覺模擬評分法. 中華關節外科雜志(電子版), 2014(2): 273.
13. 莊澤, 陳郁鮮, 梁堂釗, 等. 跟骨骨折內固定術后切口愈合不良影響因素分析. 中國骨與關節損傷雜志, 2018, 33(2): 206-208.
14. Vicenti G, Carrozzo M, Solarino G, et al. Comparison of plate, calcanealplasty and external fixation in the management of calcaneal fractures. Injury, 2019, 50(Suppl 4): S39-S46.
15. 劉凱, 王紅川, 蔣俊威, 等. 3D 打印輔助小切口復位內固定治療跟骨骨折. 華西醫學, 2016, 31(5): 859-862.
16. Dhillon MS, Bali K, Prabhakar S. Controversies in calcaneus fracture management: a systematic review of the literature. Musculoskelet Surg, 2011, 95(3): 171-181.
17. 汪洋. 跟骨骨折切開復位內固定術后軟組織并發癥的發生與手術時機的關系. 大連: 大連醫科大學, 2012.
18. Jiao L, Li H, Liao T, et al. Impact of percutaneous poking reduction combined with minimally invasive plate internal fixation on foot function and complications of patients with Sanders type II and III calcaneal fractures. Am J Transl Res, 2021, 13(5): 5329-5335.
19. Kline AJ, Anderson RB, Davis WH, et al. Minimally invasive technique versus an extensile lateral approach for intra-articular calcaneal fractures. Foot Ankle Int, 2013, 34(6): 773-780.
20. 吳新寶, 孫志堅. 加速康復外科在創傷骨科的推廣及展望. 骨科臨床與研究雜志, 2022, 7(1): 1-3.
21. 劉奎民, 姜傳強, 孫濤, 等. 天磯骨科手術機器人與傳統手術治療股骨頸骨折的直接經濟負擔比較. 骨科臨床與研究雜志, 2020, 5(3): 143-145.
22. 王永成, 劉士懂, 王超. “天璣”骨科手術機器人應用于骨盆骨折費用研究. 現代醫院管理, 2018, 16(3): 35-37.

West China Medical Journal

Safety and costs analysis of orthopedic robot-assisted treatment of calcaneal fractures based on propensity score matching

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