Robot-assisted scaphoid screw fixation versus free-hand technique for scaphoid fractures: a systematic review and meta-analysis.

This meta-analysis and systematic review set out to compare the results of robot-assisted scaphoid screw fixation to those of more conventional, manual methods of fixing scaphoid fractures. The studies pertaining to scaphoid fractures published from database inception to January 2024 were culled from PubMed, CNKI, Embase, and the Cochrane Library’s extensive database. Included studies compared conventional surgical procedures with robot-xassisted scaphoid screw fixation. Both English and Chinese versions of these articles were taken into consideration. The selection process followed recognized inclusion and exclusion criteria, with a focus on randomized controlled trials and cohort studies. We performed the meta-analysis using Review Manager 5.4.1. To assess bias in non-randomized controlled studies, we used the ROBINS-I tool. The final analysis consisted of five retrospective cohort studies and one RCT, with a total of 250 patients. Among these, 118 patients received robot-assisted scaphoid screw fixation, while 132 underwent conventional free-hand surgery. All procedures were performed percutaneously. The results demonstrated that robot-assisted scaphoid screw fixation outperformed conventional surgery in multiple areas, such as fracture healing time, Mayo wrist score, estimated blood loss, frequency of intraoperative fluoroscopy sessions, and the number of guide wire adjustments. No significant difference in VAS score and operative time was observed between the two techniques. Robot-assisted surgery for scaphoid fractures offers several advantages over traditional free-hand techniques. It enhances safety, supports better postoperative recovery, reduces the frequency of fluoroscopy for both doctors and patients and minimizes estimated blood loss. Additionally, it significantly improves long-term wrist function in patients.