Long-term outcome of robotic-guided closed reduction internal fixation for Delbet II femoral neck fractures in children

• Published in: Journal of orthopaedic surgery and research 2024-09, Vol.19 (1), p.543-8, Article 543
• Main Authors: Shen, Zhaoxiong, Liu, Zhenjiang, Shen, Chulong, Mo, Zhihong, Chen, Yongge, Guo, Yueming, Wu, Feng, Gao, Junqing
• Format: Article
• Language: English
• Subjects: Bone Screws; Care and treatment; Child; Child, Preschool; Closed Fracture Reduction - methods; Closed reduction internal fixation; Delbet type II pediatric femoral neck fracture; Female; Femoral Neck Fractures - surgery; Follow-Up Studies; Fracture Fixation, Internal - methods; Fractures; Health aspects; Humans; Internal fixation in fractures; Male; Medicine, Chinese; Navigated nail placement; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Retrospective Studies; Robotic Surgical Procedures - methods; Robots; Time Factors; TiRobot orthopaedic robot; Treatment Outcome
• ISSN: 1749-799X; 1749-799X
• DOI: 10.1186/s13018-024-05035-w

To retrospectively analyze and assess the long-term effectiveness of robotic navigation and traditional closed reduction internal fixation in the treatment of Delbet type II femoral neck fracture in children. A total of fifty-five patients diagnosed with pediatric Delbet type II femoral neck fracture, who were admitted to Foshan Hospital of Traditional Chinese Medicine between January 2018 and June 2022, were included in this study. Among them, 22 cases of nailing under robotic navigation were set as the observation group, and 33 cases of nailing under fluoroscopy of the C-arm machine were set as the control group. All patients had their femoral neck fractures closed and repositioned first. After confirming the satisfactory fracture repositioning under the fluoroscopic view of the C-arm machine, internal fixation was performed by inserting hollow compression screws in the corresponding surgical way.A comparative analysis was conducted between the two groups to assess the disparity in the amount of X-ray exposure during surgery, the number of guide pins inserted, and the duration of the surgical procedure. The quality of comparative fracture reduction was assessed according to the Haidukewych criteria on the first postoperative hip X-ray, and the parallelism and distribution of the comparative screws were measured. The incidence of hip function and postoperative complications according to the Ratliff criteria were evaluated between each of the subgroups at the final follow-up. Comparison of general information, operation duration, and quality of fracture reduction between the two groups failed to reveal statistically significant results (P > 0.05). The observation group had a lower number of X-ray exposures and guide pin placements compared to the control group, and this difference was statistically significant (P