DAI Yonghong 1,2 , LI Qingyu 1 , ZENG Yanhui 2 , WU Zhengjie 1,2 , ZHAO Chunpeng 3 , WANG Junqiang 3
  • 1. The Eighth Clinical Medical College of Guangzhou University of Chinese Medicine, Foshan Guangdong 528000, P. R. China;
  • 2. Department of Orthopedic Trauma, Foshan Hospital of Traditional Chinese Medicine, Foshan Guangdong, 528000, P. R. China;
  • 3. Department of Orthopedic Trauma, Beijing Jishuitan Hospital, Beijing, 100035, P. R. China;
ZENG Yanhui, Email: dyhgoat@163.com
Coracoid process fracture; TiRobot; screw; internal fixation; minimally invasive surgery
10.7507/1002-1892.202409072
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Objective  To explore effectiveness of TiRobot-assisted screw implantation in the treatment of coracoid process fractures of the scapula. Methods  A retrospective analysis of clinical data from 24 patients with coracoid process fractures of the scapula admitted between September 2019 and January 2024 and met selection criteria. Among them, 12 patients underwent TiRobot-assisted screw implantation (robot group) and 12 underwent manual screw implantation (control group) during internal fixation. There was no significant difference (P>0.05) in baseline data such as gender, age, body mass index, disease duration, cause of injury, coracoid process fracture classification, and proportion of patients with associated injuries between the two groups. The incision length, operation time, intraoperative blood loss, hospital stay, accuracy of screw placement, coracoid process fracture healing time, and complications were recorded and compared, as well as pain visual analogue scale (VAS) score, and Constant-Murley score at last follow-up. Results The intraoperative blood loss and incision length in the robot group were significantly lower than those in the control group (P<0.05); however, there was no significant difference in operation time and hospital stay between the two groups (P>0.05). All patients were followed up 8-27 months (mean, 17.5 months), and the difference in follow-up time between the two groups was not significant (P>0.05). At last follow-up, the VAS score for shoulder pain in the robot group were lower compared to the control group, and the Constant-Murley score was higher, with significant differences (P<0.05). In the robot group, 16 screws were implanted intraoperatively, while 13 screws were implanted in the control group. Radiographic re-evaluation showed that the excellent and good rate of screw implantation was higher in the robot group (93.8%, 15/16) than in the control group (61.5%, 8/13), but the difference in the precision of screw implantation between the two groups was not significant (P>0.05). Four patients in the robot group and 1 in the control group achieved double screws fixation; however, the difference in achieving double screws fixation between the two groups was not significant (P>0.05). All fractures healed in both groups with 1 case of malunion in the control group. There was no significant difference in healing time between the two groups (P>0.05). During follow-up, 1 patient in the control group experienced screw loosening and displacement. There was no significant difference in the incidence of screw loosening and fracture malunion between the two groups (P>0.05). Conclusion  Compared with manual screw implantation, TiRobot-assisted minimally invasive treatment of coracoid process fractures of the scapula can reduce intraoperative blood loss, shorten incision length, alleviate pain, and better promote shoulder joint functional recovery.

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