Orthopaedic Surgery (Dec 2023)

Treatment of Unstable Sacral Fractures with Robotically‐aided Minimally Invasive Triangular Fixation

  • Wei Tian,
  • Feng‐Shuang Jia,
  • Jia‐Ming Zheng,
  • Jian Jia

DOI
https://doi.org/10.1111/os.13907
Journal volume & issue
Vol. 15, no. 12
pp. 3182 – 3192

Abstract

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Objective The treatment of unstable sacral fractures is huge challenge to surgeons. Robotically‐aided minimally invasive triangular fixation (RoboTFX) is the most advanced technique up to now. This study is to evaluate the clinical outcomes of unstable sacral fractures treated with RoboTFX. Methods From March 2017 to October 2021, 48 consecutive patients with unstable sacral fractures were included in the study. All patients received surgical treatment with triangular fixation (TFX). Patients were divided into four groups according to the number of fractures (uni‐ or bilateral) and surgical method employed (RoboTFX or traditional open TFX). Between these four groups, clinical data on operation time, intraoperative bleeding, intraoperative fluoroscopy time, infection rate, fracture healing rates, insertion accuracy, Majeed pelvic outcome score, Mears' criterion, and Gibbons score were compared. Quantitative data were expressed as mean ± standard deviation and compared using Student's t‐test. Categorical variable were compared using the Pearson's χ2 test. Results Comparing unilateral RoboTFX versus open TFX, neither fracture healing rate, infection rate, Majeed pelvic outcome score, Mears' radiological evaluation criterion, nor Gibbons score of the two groups were statistically significantly different (p > 0.05). However, operation time, intraoperative bleeding, intraoperative fluoroscopy time, and insertion accuracy in the RoboTFX group were all significantly better than those of the traditional open group (p 0.05). Conclusion RoboTFX has the advantages of less operation time, less intraoperative bleeding and fluoroscopy, more accurate fixation insertion, and a higher healing rate compared to traditional open methods in the treatment of unstable sacral fractures. However, RoboTFX requires a few critical considerations, and the indications of its operation should be strictly evaluated.

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