Clinical analysis of arthroscopic-assisted reduction with robotic navigation combined in the treatment of posterior process talus fracture
Xu Mingliang1, Shi Rongjian1, Chen Guoliang1, Yuan Han1, Li Renlong1, Li Lin1, Chen Jing1, Ma Kui2
1Department of Foot and Ankle Surgery, Xuzhou Renci Hospital, Xuzhou 221004, China; 2Department of Hand and Foot Surgery, Lianyungang Donghai Limin Orthopedic Hospital, Lianyungang 222200, China
Abstract：Objective This study aimed to investigate the effect of arthroscopic-assisted reduction combined with orthopedic robot guided screw placement for the treatment of posterior talar process fracture. Methods Case series study. The clinical data of 7 patients with posterior talar process fracture who underwent surgical treatment at Xuzhou Renci Hospital from December 2019 to October 2021 were retrospectively analyzed. Among them, there were 5 males and 2 females, aged 25 to 55 (34.8±10.5) years. There were 4 cases on the left side and 3 cases on the right side. Arthroscopic-assisted reduction of talus posterior process fractures was performed in all cases, and appropriate hollow screws were placed under the guidance of the orthopedic robot. The observation indicators were intraoperative blood loss, operative time, fracture healing time, and complications. The visual analogue scale (VAS) was used to evaluate ankle pain, and the American Foot and Ankle Association (AOFAS) ankle-hindfoot function scale was used to evaluate the foot and ankle function before operation and at the last follow-up. Results All 7 patients were followed up for 13 to 27 (19.7±5.1) months, with an operative time of (107.1±27.2) minutes, a bleeding volume of (48.5±6.9) mL, and a fracture healing time of (3.7±0.7) months. There was no wound infection, nerve injury, or tendon adhesion. In addition, 2 patients had subtalar joint pain, and the pain was significantly relieved after arthroscopic subtalar joint cleaning in the second stage. At the last follow-up, the VAS score of the patient was 1.4±0.5 and AOFAS score was 91.0±3.4, which were significantly improved compared with the preoperative scores of 7.1±0.9 and 59.2±8.8. Furthermore, the differences were statistically significant (t=13.50, -11.10, all P values <0.001). The ankle joint function was excellent in six cases and good in one case. Conclusion Arthroscopic-assisted reduction combined with orthopedic robot guided screw placement for the treatment of posterior process fractures of the talus has the advantages of less trauma, less bleeding, visual reduction of fractures, and accurate screw placement. The clinical efficacy of this procedure is also satisfactory.
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Xu Mingliang, Shi Rongjian, Chen Guoliang, Yuan Han, Li Renlong, Li Lin, Chen Jing, Ma Kui. Clinical analysis of arthroscopic-assisted reduction with robotic navigation combined in the treatment of posterior process talus fracture. Chinese Journal of Anatomy and Clinics, 2023, 28(7): 436-441.
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2023, Vol. 28 
