Analysis of the effect of robot-assisted internal fixation in the treatment of femoral neck fractures and the related factors of postoperative infection

Dang Haifeng; Yang Chao; Hao Zhilong; Fan Junjun; Xue Baobao; Shi Lei

doi:10.3760/j.issn.1673-4777.2024.08.018

Abstract：Objective To study the effect of robot-assisted internal fixation in the treatment of femoral neck fractures and analyze the related factors of postoperative infection.Methods A total of 93 patients with femoral neck fracture admitted to the First Affiliated Hospital of Air Force Military Medical University from April 2019 to April 2022 were selected.They were randomly divided into control group(46 cases)and observation group(47 cases).The control group was treated with traditional freehand positioning method for internal fixation,and the observation group was treated with robot-assisted internal fixation.The operation related indicators,angle between cannulated screw and femoral neck axis,fracture healing time,Harris hip function score and complications were compared between the two groups.According to the postoperative infection,the patients were divided into infection group and non-infection group.Logistic regression model was used to analyze the influencing factors of postoperative infection.Results The intraoperative fluoroscopy time,intraoperative blood loss and the number of guide pin implantation in the observation group were shorter/less than those in the control group[(14±5)s vs(21±5)s,(8.0±3.5)ml vs(10.1±2.4)ml,(4.8±0.8)times vs(11.8±2.4)times](all P＜0.05).The angle between the cannulated screw and the femoral neck axis on the positive and lateral positions in the observation group was smaller than that in the control group,the fracture healing time was shorter than that in the control group,and the Harris hip function score was higher than that in the control group(all P＜0.05).There was no significant difference in the incidence of complications between the two groups(P＞0.05).There were 34 patients with postoperative infection and 59 patients without infection.The age ≥60 years,preoperative anemia,perioperative allogeneic blood transfusion rate,operation time and drainage tube indwelling time in the infection group were greater/longer than those in the non-infection group(all P＜0.05).Logistic regression analysis results showed that preoperative anemia,perioperative allogeneic blood transfusion,operation time and drainage tube indwelling time were independent influencing factors for postoperative infection in patients with femoral neck fracture(all P＜0.05).Conclusion Robot-assisted internal fixation for femoral neck fractures can achieve more accurate cannulated screw placement and improve the prognosis of patients.Close attention to anemia and allogeneic blood transfusion during the perioperative period can reduce postoperative infection.