TiRobot-assisted minimally invasive treatment of coracoid process fractures of scapula_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

DAI Yonghong ^1,2 , LI Qingyu ¹ ,  ZENG Yanhui ² , WU Zhengjie ^1,2 , ZHAO Chunpeng ³ , WANG Junqiang ³

1. The Eighth Clinical Medical College of Guangzhou University of Chinese Medicine, Foshan Guangdong, 528000, P. R. China;
2. Department of Orthopedic Trauma, Foshan Hospital of Traditional Chinese Medicine, Foshan Guangdong, 528000, P. R. China;
3. Department of Orthopedic Trauma, Beijing Jishuitan Hospital, Beijing, 100035, P. R. China;

Corresponding?author：

ZENG Yanhui, Email: dyhgoat@163.com

Keywords：

Coracoid process fracture; TiRobot; screw; internal fixation; minimally invasive surgery

DOI：

10.7507/1002-1892.202409072

Video：

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Objective To explore effectiveness of TiRobot-assisted screw implantation in the treatment of coracoid process fractures of the scapula. Methods A retrospective analysis was conducted on the clinical data from 24 patients with coracoid process fractures of the scapula admitted between September 2019 and January 2024 and met selection criteria. Among them, 12 patients underwent TiRobot-assisted screw implantation (robot group) and 12 underwent manual screw implantation (control group) during internal fixation. There was no significant difference (P>0.05) in baseline data such as gender, age, body mass index, disease duration, cause of injury, coracoid process fracture classification, and proportion of patients with associated injuries between the two groups. The incision length, operation time, intraoperative blood loss, hospital stay, accuracy of screw placement, coracoid process fracture healing time, and complications were recorded and compared, as well as pain visual analogue scale (VAS) score, and Constant-Murley score at last follow-up. Results The intraoperative blood loss and incision length in the robot group were significantly lower than those in the control group (P<0.05); however, there was no significant difference in operation time and hospital stay between the two groups (P>0.05). All patients were followed up 8-27 months (mean, 17.5 months), and the difference in follow-up time between the two groups was not significant (P>0.05). At last follow-up, the VAS score for shoulder pain in the robot group was signifncatly lower compared to the control group, and the Constant-Murley score was significantly higher (P<0.05). In the robot group, 16 screws were implanted intraoperatively, while 13 screws were implanted in the control group. Radiographic re-evaluation showed that the excellent and good rate of screw implantation was higher in the robot group (93.8%, 15/16) than in the control group (61.5%, 8/13), but the difference in the precision of screw implantation between the two groups was not significant (P>0.05). Four patients in the robot group and 1 in the control group achieved double screws fixation; however, the difference in achieving double screws fixation between the two groups was not significant (P>0.05). All fractures healed in both groups with 1 case of malunion in the control group. There was no significant difference in healing time between the two groups (P>0.05). During follow-up, 1 patient in the control group experienced screw loosening and displacement. There was no significant difference in the incidence of screw loosening and fracture malunion between the two groups (P>0.05). Conclusion Compared with manual screw implantation, TiRobot-assisted minimally invasive treatment of coracoid process fractures of the scapula can reduce intraoperative blood loss, shorten incision length, alleviate pain, and obtain better promote shoulder joint functional recovery.

Citation： DAI Yonghong, LI Qingyu, ZENG Yanhui, WU Zhengjie, ZHAO Chunpeng, WANG Junqiang. TiRobot-assisted minimally invasive treatment of coracoid process fractures of scapula. Chinese Journal of Reparative and Reconstructive Surgery, 2025, 39(1): 40-46. doi: 10.7507/1002-1892.202409072 Copy

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2.	Mohammed H, Skalski MR, Patel DB, et al. Coracoid process: The lighthouse of the shoulder. Radiographics, 2016, 36(7): 2084-2101.
3.	王晨, 潘虎, 費晨, 等. 機器人導航輔助置釘在空心螺釘固定治療肩胛骨喙突骨折中的應用. 中華創傷骨科雜志, 2024, 26(9): 804-809.
4.	Zou Y, Di W. Robot-assisted close reduction with double screw fixation for the coracoid-process base fracture: A case report. Asian J Surg, 2024, 47(4): 1793-1794.
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7.	賈健. 骨科定位機器人在骨盆髖臼骨折手術治療中的應用. 中華骨科雜志, 2023, 43(19): 1334-1342.
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9.	田子睿, 姚敏, 王擁軍, 等. 中文版Constant-Murley肩關節評分量表的研制與應用. 中醫正骨, 2019, 31(5): 340-341.
10.	Kawasaki Y, Hirano T, Miyatake K, et al. Safety screw fixation technique in a case of coracoid base fracture with acromioclavicular dislocation and coracoid base cross-sectional size data from a computed axial tomography study. Arch Orthop Trauma Surg, 2014, 134(7): 913-918.
11.	楊成志, 黃站珠, 唐經勵, 等. 骨科手術機器人與“O”型臂X線導航輔助骨盆骨折經皮內固定術的比較. 中華骨科雜志, 2021, 41(19): 1387-1395.
12.	朱和平, 王勇, 王強, 等. 單、雙空心螺釘治療肩胛骨喙突骨折療效比較. 中華實驗外科雜志, 2024, 41(2): 390-393.
13.	朱和平, 張盤軍, 王勇. 肩鎖關節脫位合并喙突骨折22例療效分析. 中華實驗外科雜志, 2024, 41(4): 855-858.
14.	Ogawa K, Matsumura N, Ikegami H. Coracoid fractures: therapeutic strategy and surgical outcomes. J Trauma Acute Care Surg, 2012, 72(2): E20-E26.
15.	Lo IK, Burkhart SS, Parten PM. Surgery about the coracoid: neurovascular structures at risk. Arthroscopy, 2004, 20(6): 591-595.
16.	Chuaychoosakoon C, Suwanno P, Klabklay P, et al. Proximity of the coracoid process to the neurovascular structures in various patient and shoulder positions: A cadaveric study. Arthroscopy, 2019, 35(2): 372-379.
17.	劉可心, 由夢真, 黃默冉, 等. 天璣骨科機器人聯合ArtisZeego系統微創治療骨盆骨折的初步應用研究. 中國修復重建外科雜志, 2022, 36(8): 929-933.

1. 金權赫. 探討喙突骨折的治療方法和效果. 濟南: 山東大學, 2017.
2. Mohammed H, Skalski MR, Patel DB, et al. Coracoid process: The lighthouse of the shoulder. Radiographics, 2016, 36(7): 2084-2101.
3. 王晨, 潘虎, 費晨, 等. 機器人導航輔助置釘在空心螺釘固定治療肩胛骨喙突骨折中的應用. 中華創傷骨科雜志, 2024, 26(9): 804-809.
4. Zou Y, Di W. Robot-assisted close reduction with double screw fixation for the coracoid-process base fracture: A case report. Asian J Surg, 2024, 47(4): 1793-1794.
5. 蔣守海, 張貫林, 張玉帥, 等. 機器人系統導航下閉合復位螺釘內固定治療喙突骨折1例. 中國骨與關節損傷雜志, 2021, 36(7): 684.
6. 李濤. TiRobot機器人輔助下經皮螺釘內固定治療骨盆骨折的臨床效果分析. 濟南: 山東大學, 2021.
7. 賈健. 骨科定位機器人在骨盆髖臼骨折手術治療中的應用. 中華骨科雜志, 2023, 43(19): 1334-1342.
8. 李鵬. 機器人輔助與傳統透視輔助置入骶髂螺釘治療骨盆后環骨折的Meta分析. 太原: 山西醫科大學, 2023.
9. 田子睿, 姚敏, 王擁軍, 等. 中文版Constant-Murley肩關節評分量表的研制與應用. 中醫正骨, 2019, 31(5): 340-341.
10. Kawasaki Y, Hirano T, Miyatake K, et al. Safety screw fixation technique in a case of coracoid base fracture with acromioclavicular dislocation and coracoid base cross-sectional size data from a computed axial tomography study. Arch Orthop Trauma Surg, 2014, 134(7): 913-918.
11. 楊成志, 黃站珠, 唐經勵, 等. 骨科手術機器人與“O”型臂X線導航輔助骨盆骨折經皮內固定術的比較. 中華骨科雜志, 2021, 41(19): 1387-1395.
12. 朱和平, 王勇, 王強, 等. 單、雙空心螺釘治療肩胛骨喙突骨折療效比較. 中華實驗外科雜志, 2024, 41(2): 390-393.
13. 朱和平, 張盤軍, 王勇. 肩鎖關節脫位合并喙突骨折22例療效分析. 中華實驗外科雜志, 2024, 41(4): 855-858.
14. Ogawa K, Matsumura N, Ikegami H. Coracoid fractures: therapeutic strategy and surgical outcomes. J Trauma Acute Care Surg, 2012, 72(2): E20-E26.
15. Lo IK, Burkhart SS, Parten PM. Surgery about the coracoid: neurovascular structures at risk. Arthroscopy, 2004, 20(6): 591-595.
16. Chuaychoosakoon C, Suwanno P, Klabklay P, et al. Proximity of the coracoid process to the neurovascular structures in various patient and shoulder positions: A cadaveric study. Arthroscopy, 2019, 35(2): 372-379.
17. 劉可心, 由夢真, 黃默冉, 等. 天璣骨科機器人聯合ArtisZeego系統微創治療骨盆骨折的初步應用研究. 中國修復重建外科雜志, 2022, 36(8): 929-933.

Chinese Journal of Reparative and Reconstructive Surgery

TiRobot-assisted minimally invasive treatment of coracoid process fractures of scapula

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