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.	刘振宇, 白晓冬, 高化, 等. 改良Stoppa入路切开复位钢板内固定治疗Tile B型骨盆骨折疗效分析. 中国骨与关节损伤杂志, 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.	刘涛, 孙海钰. 骨盆骨折诊疗进展. 国际骨科学杂志, 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.	陈华, 张群, 郝明, 等. 骨盆解锁复位装置复位不稳定骨盆后环损伤多中心研究. 中国修复重建外科杂志, 2022, 36(11): 1327-1334.
7.	武建超, 师政伟, 周建伟, 等. 骨盆前环骨折微创治疗研究进展. 中国修复重建外科杂志, 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.	张文辉, 王春丽, 范立真, 等. 机器人辅助导航下骶髂螺钉置入的准确性. 中国组织工程研究, 2024, 28(24): 3845-3849.
12.	贾鹏, 吴新宝. 骨科机器人辅助手术在创伤骨科的临床应用现状与发展. 中华创伤骨科杂志, 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.	李灿辉, 吴征杰, 曾焰辉, 等. 骨科手术机器人辅助与传统透视下经皮骶髂螺钉置入的优劣分析. 中国组织工程研究, 2022, 26(9): 1434-1438.
18.	Stöckle U, Schaser K, König 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.	徐练, 林旭, 吴超, 等. 两种内固定治疗骨盆前环骨折的疗效比较. 临床骨科杂志, 2024, 27(3): 390-394.
22.	刘志勤, 刘康, 邱尔钺, 等. INFIX内置支架系统联合骶髂螺钉内固定治疗Tile C型不稳定骨盆骨折疗效观察. 中国骨与关节损伤杂志, 2022, 37(2): 170-172.
23.	崔栋清, 陈斌, 孙海钰. 前环皮下内固定治疗骨盆前环损伤的研究进展. 中国骨伤, 2024, 37(5): 530-534.

1. 刘振宇, 白晓冬, 高化, 等. 改良Stoppa入路切开复位钢板内固定治疗Tile B型骨盆骨折疗效分析. 中国骨与关节损伤杂志, 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. 刘涛, 孙海钰. 骨盆骨折诊疗进展. 国际骨科学杂志, 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. 陈华, 张群, 郝明, 等. 骨盆解锁复位装置复位不稳定骨盆后环损伤多中心研究. 中国修复重建外科杂志, 2022, 36(11): 1327-1334.
7. 武建超, 师政伟, 周建伟, 等. 骨盆前环骨折微创治疗研究进展. 中国修复重建外科杂志, 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. 张文辉, 王春丽, 范立真, 等. 机器人辅助导航下骶髂螺钉置入的准确性. 中国组织工程研究, 2024, 28(24): 3845-3849.
12. 贾鹏, 吴新宝. 骨科机器人辅助手术在创伤骨科的临床应用现状与发展. 中华创伤骨科杂志, 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. 李灿辉, 吴征杰, 曾焰辉, 等. 骨科手术机器人辅助与传统透视下经皮骶髂螺钉置入的优劣分析. 中国组织工程研究, 2022, 26(9): 1434-1438.
18. Stöckle U, Schaser K, König 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. 徐练, 林旭, 吴超, 等. 两种内固定治疗骨盆前环骨折的疗效比较. 临床骨科杂志, 2024, 27(3): 390-394.
22. 刘志勤, 刘康, 邱尔钺, 等. INFIX内置支架系统联合骶髂螺钉内固定治疗Tile C型不稳定骨盆骨折疗效观察. 中国骨与关节损伤杂志, 2022, 37(2): 170-172.
23. 崔栋清, 陈斌, 孙海钰. 前环皮下内固定治疗骨盆前环损伤的研究进展. 中国骨伤, 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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