Efficacy analysis of robot-assisted minimally invasive surgery for the treatment of unstable pelvic fractures

摘要

Minimally invasive closed reduction and internal fixation of pelvic fractures represents a globally recognized challenge. The prerequisite for minimally invasive screw fixation in pelvic fractures lies in establishing screw pathways through fracture reduction. The advancement of robotic technology provides an intelligent solution for achieving minimally invasive closed reduction and internal fixation of pelvic fractures. A retrospective analysis was conducted on the medical records of 50 pelvic fracture patients who underwent surgical treatment at Foshan Hospital of Traditional Chinese Medicine from January 2022 to November 2023. Based on the surgical methods, the patients were divided into a robot group (n = 25) and a control group (n = 25). In the robot group, the pelvic fracture reduction robot (Rossum Robot) was combined with the navigation and positioning robot (TiRobot) for the treatment of pelvic fractures, with the entire reduction and fixation process performed through robotic intelligent operation. The control group underwent traditional open reduction and plate internal fixation. No statistically significant differences were observed in the general characteristics between the two groups (P > 0.05), indicating comparability. Parameters including incision length, operation time, intraoperative blood loss, hospital stay, maximum postoperative residual displacement, reduction quality, complication rates, and final follow-up Majeed pelvic function scores and grading were recorded and compared between the two groups. The operation time in the robot group was significantly longer than that in the control group, with a statistically significant difference (P < 0.05). The intraoperative blood loss and incision length in the robot group were significantly smaller than those in the control group, with statistically significant differences (P < 0.05). No statistically significant differences were observed between the two groups in terms of hospital stay, maximum postoperative residual displacement, reduction quality, or fracture healing time (P > 0.05). No iatrogenic fractures, surgical site infections, implant loosening, or nonunion were observed in either group during the perioperative period or follow-up. There were no statistically significant differences between the two groups in postoperative complications such as gait changes, iatrogenic nerve injuries, or persistent pain (P > 0.05). At the final follow-up, no statistically significant difference was found in Majeed pelvic function grading between the two groups (P > 0.05). However, the Majeed pelvic function score in the robot group was significantly higher than that in the control group, with a statistically significant difference (P < 0.05). Compared to the control group, the combination of Rossum Robot and TiRobot in the treatment of unstable pelvic fractures significantly reduced intraoperative blood loss and shortened incision length, achieving or even surpassing the reduction effect of open reduction, and better promoted pelvic function recovery.