A case-control study of minimally invasive internal fixation for pelvic fractures assisted by an orthopedic surgical robot

doi:10.3969/j.issn.1006-7795.2025.05.005

Abstract

Abstract: Objective To explore the technical advantages and applicable scenarios of surgical robot-assisted versus conventional freehand minimally invasive surgery for pelvic fractures by comparing clinical indicators, thereby providing evidence for clinical decision-making. Methods A retrospective case-control study was conducted on 59 patients with pelvic fractures treated with minimally invasive internal fixation between January 2022 and December 2024. Patients were divided into a conventional group (26 cases) and a robot-assisted navigation group (33 cases) based on the surgical technique. Pre- and postoperative pelvic computed tomography (CT) scans were performed, and anteroposterior, outlet, and inlet view radiographs were obtained. The maximum residual displacement after pelvic reduction and screw placement accuracy were measured based on radiographic and CT imaging. Intraoperative fluoroscopy frequency, radiation dose, operative time, blood loss, number of implanted screws , maximum residual displacement after reduction, and screw accuracy were recorded. Results No significant differences were observed between the two groups in age, gender, injury mechanism, or fracture classification, indicating comparability. Blood loss and fracture reduction quality showed no significant differences. The operative time was 52.5(30.8, 62.3) min in the conventional group and 60(50, 82.5) min in the robot-assisted group. Intraoperative fluoroscopy frequency and radiation dose were (19.1 ± 5.4) times and 33.1(27.5, 43.9) mGy in the conventional group, compared to (12.1 ± 4.9) times and 123.1(101.1, 131.4) mGy in the robot-assisted group. The robot-assisted group demonstrated superior screw placement accuracy, increased utilization of anterior column screws, and shorter postoperative ambulation time. Conclusion Robot-assisted minimally invasive surgery for pelvic fractures significantly outperforms conventional freehand techniques in improving screw placement accuracy and reducing radiation exposure for surgeons. It represents a preferable option for treating unstable pelvic fractures.

Key words: pelvic fracture, robotic surgery, navigation, sacroiliac screw, minimally invasive surgery, radiation exposure

CLC Number:

R683

Long Anhua, Zhang Jiafan, Yang Qi, Wang Xiongfei, Zhang Yakui, Wang Xuefei, Liu Liang. A case-control study of minimally invasive internal fixation for pelvic fractures assisted by an orthopedic surgical robot[J]. Journal of Capital Medical University, doi: 10.3969/j.issn.1006-7795.2025.05.005.

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