The clinical efficacy of robot-assisted internal fixation with sacroiliac screws for posterior pelvic ring fractures: a meta-analysis
10.3760/cma.j.cn121113-20230328-00171
- VernacularTitle:机器人辅助骶髂螺钉内固定治疗骨盆后环骨折临床疗效的meta分析
- Author:
Zhi LIU
1
;
Guoqing YIN
;
Shushan ZHAO
;
Ruibo ZHAO
;
Haitao LONG
;
Liang CHENG
;
Bangbao LU
;
Buhua SUN
;
Ming ZENG
;
Can CHEN
;
Yong ZHU
;
Zhangyuan LIN
Author Information
1. 中南大学湘雅医院骨科，长沙 410008
- Keywords:
Pelvis;
Fractures, bone;
Robotics;
Fracture fixation, internal;
Meta-analysis
- From:
Chinese Journal of Orthopaedics
2023;43(19):1324-1333
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the clinical efficacy of robot-assisted versus fluoroscopy-assisted sacroiliac screw internal fixation for posterior pelvic ring fractures.Methods:China National Knowledge Infrastructure (CNKI), Wanfang Data, Chinese Medical Journal Full-text Database, PubMed, Web of Science and ScienceDirect were searched for literature on robot-assisted versus fluoroscopy-assisted sacroiliac screw internal fixation for posterior pelvic ring fractures. The search time was from the establishment of each database to March 2023. Meta-analysis was performed on the included literature. The random-effects model was used when the heterogeneity between groups was large, and the fixed-effects model was used when the heterogeneity between groups was small.Results:A total of 15 studies were included in the meta-analysis, including 465 patients in the robot-assisted group and 396 patients in the fluoroscopy-assisted group. Meta-analysis showed that the number of fluoroscopies [ SMD=-3.12, 95% CI (-4.34, -1.89), P<0.001], the number of guide pin adjustments [ SMD=-3.75, 95% CI (-6.77, -0.72), P=0.015], intraoperative blood loss [ SMD=-0.83, 95% CI (-1.18, -0.49), P<0.001], and operative time [ SMD=-2.59, 95% CI (-4.11, -1.08), P<0.001] were smaller than those in the fluoroscopy-assisted group. The rate of excellent screw implantation [ OR=10.13, 95% CI (3.67,27.98), P<0.001] of the robot-assisted was larger than the fluoroscopy-assisted group. There was no significant difference in Majeed functional score [ SMD=0.28, 95% CI (-0.0003, 0.55), P=0.050] and fracture healing time [ SMD=-0.14, 95% CI (-0.46, 0.17), P=0.367] between the two groups. Conclusion:Robot-assisted percutaneous sacroiliac screw fixation for posterior pelvic ring fractures has the advantages of less fluoroscopy, less guide pin adjustment, less intraoperative blood loss, shorter operation time, and higher rate of excellent screw position. However, there is no difference in Majeed score and fracture healing time between robot-assisted percutaneous sacroiliac screw fixation and fluoroscopy-assisted percutaneous sacroiliac screw fixation.
