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Peer-reviewedCC BYFrontiers in medicine

Robot-assisted navigation combined with a double reverse traction reduction frame for retrograde intramedullary nailing of extra-articular distal femoral fractures: a retrospective comparative cohort study

  • Bo Wu1
  • Bing Du1
  • Yuhang Liu1
  • Xianjie Ai1
  • Chengcheng Zhang1
  • Hongfei Qi1
  • Zhong Li1
  • Xiaye Lv2
  • Ming Li1
  1. 1Lower Extremity Division, Orthopedic Trauma Department, Honghui Hospital, Xi’an Jiaotong University , ,
  2. 2Department of Hematology and Oncology, Honghui Hospital, Xi’an Jiaotong University , ,
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Abstract

Objective: To compare the perioperative, radiographic, and functional outcomes associated with an integrated surgical workflow combining robot-assisted navigation with a double reverse traction reduction frame vs. conventional manual traction.

Methods: This retrospective comparative cohort study was conducted on 58 patients (AO/OTA 33-A1 or 33-A2) with distal femoral fractures treated between January 2021 and December 2024. Patients were divided into a robot-assisted double reverse traction reduction group (RDR group, n = 26) and a conventional manual traction group (CMT group, n = 32). All patients underwent retrograde intramedullary nailing. The RDR group received robot-assisted guidewire positioning combined with continuous traction-frame-assisted fracture reduction, whereas the CMT group underwent conventional manual traction reduction. Perioperative parameters, radiographic outcomes, functional scores, and complications were analyzed.

Results: The groups were similar in the measured baseline demographic and fracture characteristics, including AO/OTA subtype. Compared with the CMT group, the RDR group showed significantly reduced operative time, decreased intraoperative blood loss, fewer fluoroscopic acquisitions, smaller residual coronal and sagittal angulation, and shorter fracture healing time. At the 12-month follow-up, knee flexion angle and Hospital for Special Surgery (HSS) knee score were significantly higher in the RDR group. No significant difference in complication rates was observed between groups.

Conclusion: In this retrospective comparative cohort, the integrated workflow was associated with shorter operative time, lower intraoperative blood loss, fewer fluoroscopic acquisitions, improved postoperative alignment, and better 12-month knee function compared with conventional manual traction.

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Cite

BibTeXRIS
BibTeX
@article{wu2026robotassisted,
  title = {{Robot-assisted navigation combined with a double reverse traction reduction frame for retrograde intramedullary nailing of extra-articular distal femoral fractures: a retrospective comparative cohort study}},
  author = {Bo Wu and Bing Du and Yuhang Liu and Xianjie Ai and Chengcheng Zhang and Hongfei Qi and Zhong Li and Xiaye Lv and Ming Li},
  journal = {Frontiers in medicine},
  year = {2026},
  month = oct,
  doi = {10.3389/fmed.2026.1929866},
  url = {https://europepmc.org/article/PMC/PMC13724628},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Robot-assisted navigation combined with a double reverse traction reduction frame for retrograde intramedullary nailing of extra-articular distal femoral fractures: a retrospective comparative cohort study
AU  - Bo Wu
AU  - Bing Du
AU  - Yuhang Liu
AU  - Xianjie Ai
AU  - Chengcheng Zhang
AU  - Hongfei Qi
AU  - Zhong Li
AU  - Xiaye Lv
AU  - Ming Li
PY  - 2026
DA  - 2026/10/19
JO  - Frontiers in medicine
DO  - 10.3389/fmed.2026.1929866
UR  - https://europepmc.org/article/PMC/PMC13724628
AB  - Objective: To compare the perioperative, radiographic, and functional outcomes associated with an integrated surgical workflow combining robot-assisted navigation with a double reverse traction reduction frame vs. conventional manual traction.  Methods: This retrospective comparative cohort study was conducted on 58 patients (AO/OTA 33-A1 or 33-A2) with distal femoral fractures treated between January 2021 and December 2024. Patients were divided into a robot-assisted double reverse traction reduction group (RDR group, n = 26) and a conventional manual traction group (CMT group, n = 32). All patients underwent retrograde intramedullary nailing. The RDR group received robot-assisted guidewire positioning combined with continuous traction-frame-assisted fracture reduction, whereas the CMT group underwent conventional manual traction reduction. Perioperative parameters, radiographic outcomes, functional scores, and complications were analyzed.  Results: The groups were similar in the measured baseline demographic and fracture characteristics, including AO/OTA subtype. Compared with the CMT group, the RDR group showed significantly reduced operative time, decreased intraoperative blood loss, fewer fluoroscopic acquisitions, smaller residual coronal and sagittal angulation, and shorter fracture healing time. At the 12-month follow-up, knee flexion angle and Hospital for Special Surgery (HSS) knee score were significantly higher in the RDR group. No significant difference in complication rates was observed between groups.  Conclusion: In this retrospective comparative cohort, the integrated workflow was associated with shorter operative time, lower intraoperative blood loss, fewer fluoroscopic acquisitions, improved postoperative alignment, and better 12-month knee function compared with conventional manual traction.
SN  - 2296-858X
ER  -