Effectiveness of reduction robot combined with navigation robot-assisted minimally invasive treatment for Tile type B pelvic fractures_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

LIAO Jiangbo ¹ , DAI Yonghong ¹ ,  WU Zhengjie ² , ZENG Yanhui ² , LI Canhui ² , WANG Xuelin ¹ , WANG Junqiang ³ , ZHAO Chunpeng ³ , WU Xinbao ³

1. The Eighth Clinical Medical College of Guangzhou University of Traditional Chinese Medicine, Foshan Guangdong, 528000, P. R. China;
2. The Seventh Department of Orthopedics, Foshan Hospital of Traditional Chinese Medicine, Foshan Guangdong, 528000, P. R. China;
3. Department of Orthopedics, Beijing Jishuitan Hospital, Beijing, 102208, P. R. China;

Corresponding?author：

WU Zhengjie, Email: 13902414988@163.com

Keywords：

Pelvic fracture; robotic surgery; closed reduction; internal fixation

DOI：

10.7507/1002-1892.202404049

Video：

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Objective To explore the effectiveness of reduction robot combined with navigation robot-assisted minimally invasive treatment for Tile type B pelvic fractures. Methods Between January 2022 and February 2023, 10 patients with Tile type B pelvic fractures were admitted. There were 6 males and 4 females with an average age of 45.5 years (range, 30-71 years). The fractures were caused by traffic accident in 5 cases, bruising by heavy object in 3 cases, and falling from height in 2 cases. The interval between injury and operation ranged from 4-13 days (mean, 6.8 days). There were 2 cases of Tile type B1 fractures, 1 case of Tile type B2 fracture, and 7 cases of Tile type B3 fractures. After closed reduction under assistance of reduction robot, the anterior ring was fixed with percutaneous screws with or without internal fixator, and the posterior ring was fixed with sacroiliac joint screws under assistance of navigation robot. The time of fracture reduction assisted by the reduction robot was recorded and the quality of fracture reduction was evaluated according to the Matta scoring criteria. The operation time, intraoperative fluoroscopy frequency and time, intraoperative bleeding volume, and incidence of complications were also recorded. During follow-up, the X-ray film of pelvis was taken to review the fracture healing, and the Majeed score was used to evaluate hip joint function. Results The time of fracture reduction was 42-62 minutes (mean, 52.3 minutes). The quality of fracture reduction according to the Matta scoring criteria was rated as excellent in 4 cases, good in 5 cases, and poor in 1 case, with excellent and good rate of 90%. The operation time was 180-235 minutes (mean, 215.5 minutes). Intraoperative fluoroscopy was performed 18-66 times (mean, 31.8 times). Intraoperative fluoroscopy time was 16-59 seconds (mean, 28.6 seconds). The intraoperative bleeding volume was 50-200 mL (range, 110.0 mL). No significant vascular or nerve injury occurred during operation. All patients were followed up 13-18 months (mean, 16 months). X-ray films showed that all fractures healed with the healing time of 11-14 weeks (mean, 12.3 weeks). One case of ectopic ossification occurred during follow-up. At last follow-up, the Majeed score was 70-92 (mean, 72.7), and the hip joint function was rated as excellent in 2 cases and good in 8 cases, with the excellent and good rate of 100%. Conclusion The reduction robot combined with navigation robot-assisted minimally invasive treatment for Tile type B pelvic fractures has the characteristics of intelligence, high safety, convenient operation, and minimally invasive treatment, which can achieve reliable effectiveness.

Citation： LIAO Jiangbo, DAI Yonghong, WU Zhengjie, ZENG Yanhui, LI Canhui, WANG Xuelin, WANG Junqiang, ZHAO Chunpeng, WU Xinbao. Effectiveness of reduction robot combined with navigation robot-assisted minimally invasive treatment for Tile type B pelvic fractures. Chinese Journal of Reparative and Reconstructive Surgery, 2024, 38(8): 954-960. doi: 10.7507/1002-1892.202404049 Copy

1.	劉振宇, 白曉冬, 高化, 等. 改良Stoppa入路切開復位鋼板內固定治療Tile B型骨盆骨折療效分析. 中國骨與關節損傷雜志, 2023, 38(2): 160-163.
2.	Hu S, Guo J, Zhu B, et al. Epidemiology and burden of pelvic fractures: Results from the Global Burden of Disease Study 2019. Injury, 2023, 54(2): 589-597.
3.	劉濤, 孫海鈺. 骨盆骨折診療進展. 國際骨科學雜志, 2024, 45(1): 27-32.
4.	Matta JM, Yerasimides JG. Table-skeletal fixation as an adjunct to pelvic ring reduction. J Orthop Trauma, 2007, 21(9): 647-656.
5.	Lefaivre KA, Starr AJ, Barker BP, et al. Early experience with reduction of displaced disruption of the pelvic ring using a pelvic reduction frame. J Bone Joint Surg (Br), 2009, 91(9): 1201-1207.
6.	陳華, 張群, 郝明, 等. 骨盆解鎖復位裝置復位不穩定骨盆后環損傷多中心研究. 中國修復重建外科雜志, 2022, 36(11): 1327-1334.
7.	武建超, 師政偉, 周建偉, 等. 骨盆前環骨折微創治療研究進展. 中國修復重建外科雜志, 2020, 34(4): 529-535.
8.	Ge Y, Zhao C, Wang Y, et al. Robot-assisted autonomous reduction of a displaced pelvic fracture: a case report and brief literature review. J Clin Med, 2022, 11(6): 1598. doi: 10.3390/jcm11061598.
9.	Zhao C, Cao Q, Sun X, et al. Intelligent robot-assisted minimally invasive reduction system for reduction of unstable pelvic fractures. Injury, 2023, 54(2): 604-614.
10.	Mudawi A, Alzobi O, Derbas JN, et al. Optimizing percutaneous reduction and fixation with guidewire modification in pelvic and acetabular fractures: surgical technique and case series. Eur J Orthop Surg Traumatol, 2024, 34(4): 2107-2112.
11.	張文輝, 王春麗, 范立真, 等. 機器人輔助導航下骶髂螺釘置入的準確性. 中國組織工程研究, 2024, 28(24): 3845-3849.
12.	賈鵬, 吳新寶. 骨科機器人輔助手術在創傷骨科的臨床應用現狀與發展. 中華創傷骨科雜志, 2023, 25(5): 433-439.
13.	Tornetta P, Matta JM. Outcome of operatively treated unstable posterior pelvic ring disruptions. Clin Orthop Relat Res, 1996(329): 186-193.
14.	Majeed SA. Grading the outcome of pelvic fractures. J Bone Joint Surg (Br), 1989, 71(2): 304-306.
15.	Wang LF, Wang TM, Li CS, et al. Physical symmetry and virtual plane-based reduction reference: a preliminary study for robot-assisted pelvic fracture reduction. J Mech Med Biol, 2016, 16(8): 1640014. doi: 10.1142/S0219519416400145.
16.	Liu JX, Xu K, Zhao CP, et al. Experimental and finite element analysis studies of a reduction-force reducing traction method for pelvic fracture surgeries. Med Nov Technol Devices, 2022, 13: 100101. doi: 10.1016/j.medntd.2021.100101.
17.	李燦輝, 吳征杰, 曾焰輝, 等. 骨科手術機器人輔助與傳統透視下經皮骶髂螺釘置入的優劣分析. 中國組織工程研究, 2022, 26(9): 1434-1438.
18.	St?ckle U, Schaser K, K?nig B. Image guidance in pelvic and acetabular surgery—expectations, success and limitations. Injury, 2007, 38(4): 450-462.
19.	Ansari M, Kawedia A, Chaudhari HH, et al. Functional outcome of internal fixation (INFIX) in anterior pelvic ring fractures. Cureus, 2023, 15(3): e36134. doi: 10.7759/cureus.36134.
20.	Sharma S, Aggarwal S, Patel S, et al. INFIX-safe and effective surgical option for complex fracture patterns of the anterior pelvic ring: A prospective single center study. J Orthop, 2021, 23: 142-149.
21.	徐練, 林旭, 吳超, 等. 兩種內固定治療骨盆前環骨折的療效比較. 臨床骨科雜志, 2024, 27(3): 390-394.
22.	劉志勤, 劉康, 邱爾鉞, 等. INFIX內置支架系統聯合骶髂螺釘內固定治療Tile C型不穩定骨盆骨折療效觀察. 中國骨與關節損傷雜志, 2022, 37(2): 170-172.
23.	崔棟清, 陳斌, 孫海鈺. 前環皮下內固定治療骨盆前環損傷的研究進展. 中國骨傷, 2024, 37(5): 530-534.

1. 劉振宇, 白曉冬, 高化, 等. 改良Stoppa入路切開復位鋼板內固定治療Tile B型骨盆骨折療效分析. 中國骨與關節損傷雜志, 2023, 38(2): 160-163.
2. Hu S, Guo J, Zhu B, et al. Epidemiology and burden of pelvic fractures: Results from the Global Burden of Disease Study 2019. Injury, 2023, 54(2): 589-597.
3. 劉濤, 孫海鈺. 骨盆骨折診療進展. 國際骨科學雜志, 2024, 45(1): 27-32.
4. Matta JM, Yerasimides JG. Table-skeletal fixation as an adjunct to pelvic ring reduction. J Orthop Trauma, 2007, 21(9): 647-656.
5. Lefaivre KA, Starr AJ, Barker BP, et al. Early experience with reduction of displaced disruption of the pelvic ring using a pelvic reduction frame. J Bone Joint Surg (Br), 2009, 91(9): 1201-1207.
6. 陳華, 張群, 郝明, 等. 骨盆解鎖復位裝置復位不穩定骨盆后環損傷多中心研究. 中國修復重建外科雜志, 2022, 36(11): 1327-1334.
7. 武建超, 師政偉, 周建偉, 等. 骨盆前環骨折微創治療研究進展. 中國修復重建外科雜志, 2020, 34(4): 529-535.
8. Ge Y, Zhao C, Wang Y, et al. Robot-assisted autonomous reduction of a displaced pelvic fracture: a case report and brief literature review. J Clin Med, 2022, 11(6): 1598. doi: 10.3390/jcm11061598.
9. Zhao C, Cao Q, Sun X, et al. Intelligent robot-assisted minimally invasive reduction system for reduction of unstable pelvic fractures. Injury, 2023, 54(2): 604-614.
10. Mudawi A, Alzobi O, Derbas JN, et al. Optimizing percutaneous reduction and fixation with guidewire modification in pelvic and acetabular fractures: surgical technique and case series. Eur J Orthop Surg Traumatol, 2024, 34(4): 2107-2112.
11. 張文輝, 王春麗, 范立真, 等. 機器人輔助導航下骶髂螺釘置入的準確性. 中國組織工程研究, 2024, 28(24): 3845-3849.
12. 賈鵬, 吳新寶. 骨科機器人輔助手術在創傷骨科的臨床應用現狀與發展. 中華創傷骨科雜志, 2023, 25(5): 433-439.
13. Tornetta P, Matta JM. Outcome of operatively treated unstable posterior pelvic ring disruptions. Clin Orthop Relat Res, 1996(329): 186-193.
14. Majeed SA. Grading the outcome of pelvic fractures. J Bone Joint Surg (Br), 1989, 71(2): 304-306.
15. Wang LF, Wang TM, Li CS, et al. Physical symmetry and virtual plane-based reduction reference: a preliminary study for robot-assisted pelvic fracture reduction. J Mech Med Biol, 2016, 16(8): 1640014. doi: 10.1142/S0219519416400145.
16. Liu JX, Xu K, Zhao CP, et al. Experimental and finite element analysis studies of a reduction-force reducing traction method for pelvic fracture surgeries. Med Nov Technol Devices, 2022, 13: 100101. doi: 10.1016/j.medntd.2021.100101.
17. 李燦輝, 吳征杰, 曾焰輝, 等. 骨科手術機器人輔助與傳統透視下經皮骶髂螺釘置入的優劣分析. 中國組織工程研究, 2022, 26(9): 1434-1438.
18. St?ckle U, Schaser K, K?nig B. Image guidance in pelvic and acetabular surgery—expectations, success and limitations. Injury, 2007, 38(4): 450-462.
19. Ansari M, Kawedia A, Chaudhari HH, et al. Functional outcome of internal fixation (INFIX) in anterior pelvic ring fractures. Cureus, 2023, 15(3): e36134. doi: 10.7759/cureus.36134.
20. Sharma S, Aggarwal S, Patel S, et al. INFIX-safe and effective surgical option for complex fracture patterns of the anterior pelvic ring: A prospective single center study. J Orthop, 2021, 23: 142-149.
21. 徐練, 林旭, 吳超, 等. 兩種內固定治療骨盆前環骨折的療效比較. 臨床骨科雜志, 2024, 27(3): 390-394.
22. 劉志勤, 劉康, 邱爾鉞, 等. INFIX內置支架系統聯合骶髂螺釘內固定治療Tile C型不穩定骨盆骨折療效觀察. 中國骨與關節損傷雜志, 2022, 37(2): 170-172.
23. 崔棟清, 陳斌, 孫海鈺. 前環皮下內固定治療骨盆前環損傷的研究進展. 中國骨傷, 2024, 37(5): 530-534.

Chinese Journal of Reparative and Reconstructive Surgery

Effectiveness of reduction robot combined with navigation robot-assisted minimally invasive treatment for Tile type B pelvic fractures

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