Comparison of short-term efficacy of orthopedic robot-assisted and traditional fluoroscopy-guided sustentaculum tali screw fixation of Sanders type II and III calcaneal fracture / 中华创伤杂志

ABSTRACT

Objective:To compare the short-term efficacy of orthopedic robot-assisted and traditional fluoroscopy-guided sustentaculum talus screw fixation of Sanders type II and III calcaneal fracture with.Methods:A retrospective cohort study was conducted to analyze the clinical data of 54 patients with Sanders type II and III calcaneal fracture admitted to People′s Hospital of Nanchang County of Jiangxi Province from October 2020 to October 2021, including 30 males and 24 females; aged 29-57 years [(39.5±7.4)years]. Type of fracture was Sanders type II in 38 feet and Sanders type III in 22 feet. Sustentaculum talus screw fixation was performed using orthopedic robot-assisted technique in robot group (26 patients, 28 feet) and using intraoperative fluoroscopy-guided technique in freehand group (28 patients, 32 feet). The intraoperative fluoroscopy frequency, incision length, intraoperative blood loss and operation time were recorded. Calcaneus width, B?hler angle and Gissane angle were measured preoperatively and at 3-, 6-month postoperatively. Foot function was assessed using the Maryland scale at 6 months after operation. Postoperative complications were observed.Results:All patients were followed up for 6-8 months [(6.9±0.7)months]. The intraoperative fluoroscopy frequency and operation time were (2.8±0.7)times and (46.9±2.4)minutes in robot group, compared to (10.1±2.0)times and (75.6±3.1)minutes in freehand group (all P<0.01). There was no significant difference in the incision length and intraoperative blood loss between the two groups (all P>0.05). The calcaneus width, B?hler angle and Gissane angle in the two groups were improved at postoperative 3, 6 months when compared with preoperative ones (all P<0.05), and the improvement was much better in robot group than that in freehand group ( P<0.05 or 0.01). The excellent and good rate of Maryland score was 100% (28/28) (21 excellent, 7 good) in robot group at postoperative 6 months, compared to 78.1% (25/32) (19 excellent, 6 good, 7 fair) in freehand group ( P<0.05). The postoperative complication rate was 0% (0/28) in robot group and was 6.3% (2/32) in freehand group ( P>0.05). Conclusion:For Sanders type II and III calcaneal fracture, orthopedic robot-assisted sustentaculum talus screw fixation is superior to traditional fluoroscopy-guided internal fixation since it can significantly reduce intraoperative fluoroscopy frequency, shorten operation time, improve calcaneus width, B?hler angle and Gissane angle, and achieve better foot function.