Enhanced accuracy and reduced complications: robot-assisted navigation for retrograde intramedullary nailing in distal femoral fractures.

Abstract

Purpose: This research investigates the benefits of robot-assisted navigation systems in retrograde intramedullary nailing for distal femoral fractures and contrasts their outcomes with conventional surgical methods. This is a retrospective clinical study designed to compare the outcomes of these two approaches.

Methods: This study included 56 distal femoral fracture patients treated between February 2020 and May 2023. Among them, 28 patients underwent robot-assisted retrograde intramedullary nailing (robot group), while 28 received conventional retrograde intramedullary nailing (traditional group). Surgical duration, intraoperative fluoroscopy frequency, number of guidewire insertions into the femoral medullary cavity, and intraoperative blood loss were recorded. Healing progress and fixation stability status were observed, and postoperative articular function was assessed using Neer's scoring system at a one year follow-up.

Results: Baseline characteristics were comparable between the two groups, showing no statistically significant differences.The robot group demonstrated shorter operative time, fewer guidewire placements, reduced intraoperative hemorrhage and incision size compared to the traditional group (P < 0.05). While the Neer's score for postoperative joint function showed a higher excellent-to-good rate in the robot group, no significant difference was observed between the group (P > 0.05).

Conclusion: Compared with traditional surgical methods, robot-assisted retrograde intramedullary fixation for fractures of the distal femur offers advantages of being minimally invasive, more precise, requiring shorter operative times, and resulting in reduced blood loss, fluoroscopy exposure, and guidewire insertion attempts. These benefits may contribute to a reduction in postoperative complications.