TiRobot-assisted channel screw fixation for elderly patients with fragility fractures of the pelvis: A retrospective study

Abstract

Abstract Objective The incidence of fragility fracture of the pelvis (FFP) in the elderly population is increasing, and FFP that require fixation are a challenge for orthopedic surgeons. The aim of the study was to investigate the clinical efficacy of TiRobot-assisted channel screws fixation in the treatment of elderly FFP patients. Method Between May 2020 and September 2022, 46 elderly FFP patients were separately treated using channel screws fixation assisted by the TiRobot (TiRobot-assisted group) and conventional freehand surgery (freehand group). Postoperative outcomes between groups, including excellent and good fracture reduction based on Matta criteria and screw implantation accuracy based on Gras criteria, were compared. Changes in the Visual Analog Scale (VAS) pain score and the Majeed score (reflecting functional recovery) were recorded and compared between groups before and after surgery and during the 24-week of follow-up. Results A total of 90 screws were placed in all patients. Fifty-one screws were implanted in the TiRobot-assisted group (24 patients) and 39 screws (22 patients) in the freehand group. There were no screw-related complications or revision surgery in any group. The Matta value of TiRobot-assisted group was 5.13 ± 3.52, which was significantly lower than that of freehand group (9.00 ± 3.68); the excellent and good rate of the former (91.67%) was significantly higher than that of the latter (72.73%), and the differences were statistically significant (p = 0.0007; p < 0.001). In terms of screw placement, the accuracy rate was 100% in the TiRobot-assisted group, better than that in the freehand group where it was only 85.7% (p < 0.001). At each time point in the early postoperative period, the VAS score of the TiRobot-assisted group was significantly lower than that of the freehand group (all p < 0.05), and was close to consistent by the last follow-up. While the Majeed score of the former was significantly higher than that of the latter at each time point of follow-up; the difference between the two groups was statistically significant (all p < 0.0001). Conclusion TiRobot-assisted channel screw fixation of elderly FFP patients is advantageous over conventional freehand surgery, with less invasion, more precise positioning, more accurate screw placement, better fracture reduction, early pain relief and rapid recovery, suggesting that it is a better method to stabilize FFP in the elderly population.