{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T01:19:12Z","timestamp":1787879952603,"version":"build-2784847793"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T00:00:00Z","timestamp":1771372800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"The scientific and technological Innovation team of Joint Logistic Support Force of PLA"},{"name":"Medical key subject of Joint Logistic Support Force of PLA"},{"name":"Clinical Key Subject Construction Project of PLA"},{"name":"Yunnan Orthopedics and Sports Rehabilitation Clinical Medicine Research Center","award":["2022YFC2405704"],"award-info":[{"award-number":["2022YFC2405704"]}]},{"name":"Yunnan Provincial Clinical Orthopaedic Trauma Medical Center"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The objective of the study was to evaluate the safety, feasibility, and radiographic outcomes of an intelligent robot-assisted fracture reduction (RAFR) system in the minimally invasive treatment of fresh, unstable pelvic ring injuries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this single-center retrospective case series, 32 consecutive patients with unstable pelvic ring injuries (Tile type B or C) treated between August 2024 and April 2025 underwent minimally invasive closed reduction and internal fixation using the RAFR system. The system combines preoperative computed tomography (CT)-based three-dimensional reduction planning, intraoperative cone-beam CT (CBCT) registration, an optical tracking system, a table-mounted passive holding arm, and a robotic arm with dual force\u2013position monitoring. Operative time, intraoperative blood loss, and fluoroscopic exposures were recorded. Postoperative CT was used to measure residual displacement, which was graded according to Matta\u2019s criteria, and the excellent-to-good rate was calculated. Functional outcomes were assessed using the Majeed score at the final follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>All 32 procedures were completed using a closed, minimally invasive approach without conversion to open reduction. The median (IQR) operative time was 270 (225\u2013311) min, blood loss was 150 (100\u2013300) mL, and fluoroscopic exposures were 35 (30\u201345). The median residual displacement on CT was 4.0 (3.0\u20138.0) mm. According to Matta\u2019s criteria, 17 patients (53.1%) had excellent, 12 (37.5%) had good, and 3 (9.4%) had fair reductions, yielding an excellent-to-good rate of 90.6%. Two patients were lost to follow-up; among the remaining 30 patients, no major complications such as deep infection, implant failure, or iatrogenic neurovascular injury were observed, and the mean Majeed score was 76.7\u202f\u00b1\u202f12.0.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The RAFR system enabled closed reduction and percutaneous fixation of a heterogeneous cohort of unstable pelvic ring fractures with high rates of satisfactory reduction and favorable short-term functional recovery. These preliminary findings support the clinical feasibility and safety of robot-assisted closed reduction for unstable pelvic fractures and provide a basis for future comparative and multicenter studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1744048","type":"journal-article","created":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T12:17:38Z","timestamp":1771417058000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Intelligent robot-assisted fracture reduction for pelvic fractures: a clinical study"],"prefix":"10.3389","volume":"13","author":[{"given":"Xinyu","family":"Fan","sequence":"first","affiliation":[{"name":"920th Hospital of Joint Logistics Support Force","place":["Kunming, Yunnan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianlin","family":"He","sequence":"additional","affiliation":[{"name":"920th Hospital of Joint Logistics Support Force","place":["Kunming, Yunnan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baochuang","family":"Qi","sequence":"additional","affiliation":[{"name":"Orthopedic Trauma Center, Yunnan Provincial Hospital of Traditional Chinese Medicine\/The First Affiliated Hospital of Yunnan University of Chinese Medicine","place":["Kunming, Yunnan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hu","family":"Zhang","sequence":"additional","affiliation":[{"name":"920th Hospital of Joint Logistics Support Force","place":["Kunming, Yunnan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gang","family":"Li","sequence":"additional","affiliation":[{"name":"920th Hospital of Joint Logistics Support Force","place":["Kunming, Yunnan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xingqiang","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Hospital of Guizhou Panjiang Coal and Electricity Group Co., Ltd.","place":["Guizhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Yu","sequence":"additional","affiliation":[{"name":"School of Clinical Medicine, Dali University","place":["Dali, Yunnan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nuocheng","family":"Yang","sequence":"additional","affiliation":[{"name":"School of Clinical Medicine, Dali University","place":["Dali, Yunnan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yin","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Dali Bai Autonomous Prefecture People\u2019s Hospital, Dali","place":["Yunnan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongqing","family":"Xu","sequence":"additional","affiliation":[{"name":"920th Hospital of Joint Logistics Support Force","place":["Kunming, Yunnan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,18]]},"reference":[{"key":"ref1","first-page":"78","article-title":"Pelvic ring injuries: a challenge for the trauma surgeon","volume":"96","author":"Rommens","year":"1996","journal-title":"Acta Chir Belg"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"458","DOI":"10.5435\/JAAOS-21-08-458","article-title":"Pelvic fractures: part 2. Contemporary indications and techniques for definitive surgical management","volume":"21","author":"Langford","year":"2013","journal-title":"J Am Acad Orthop Surg"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"283","DOI":"10.1016\/j.jot.2024.08.023","article-title":"Innovative development of robot reduction system in geriatric pelvic fractures: a single-center case series in Beijing, China","volume":"49","author":"Zhao","year":"2024","journal-title":"Front Surg"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"e5614","DOI":"10.7759\/cureus.5614","article-title":"Fixation of crescent pelvic fracture in a tertiary care hospital: a steep learning curve","volume":"11","author":"Jatoi","year":"2019","journal-title":"Cureus"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"341","DOI":"10.1111\/os.12452","article-title":"Guidance for treatment of pelvic acetabular injuries with precise minimally invasive internal fixation based on the orthopaedic surgery robot positioning system","volume":"11","author":"Wu","year":"2019","journal-title":"Orthop Surg"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1016\/j.otsr.2016.12.002","article-title":"Open reduction internal fixation versus percutaneous iliosacral screw fixation for unstable posterior pelvic ring disruptions","volume":"103","author":"Elzohairy","year":"2017","journal-title":"Orthop Traumatol Surg Res"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1097\/00003086-200006000-00004","article-title":"Percutaneous fixation of pelvic ring disruptions","volume":"375","author":"Routt","year":"2000","journal-title":"Clin Orthop Relat Res"},{"key":"ref8","volume-title":"Minimally invasive treatment of pelvic and acetabular fractures","author":"Chen","year":"2016"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"919","DOI":"10.3760\/cma.j.issn.1001-8050.2018.10.011","article-title":"External pelvic reduction frame system combined with tunnel screw fixation for tile C1 pelvic fracture","volume":"34","author":"Chen","year":"2018","journal-title":"Chin J Trauma"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1111\/os.12423","article-title":"Robot-assisted minimally-invasive internal fixation of pelvic ring injuries: a single-center experience","volume":"11","author":"Liu","year":"2019","journal-title":"Orthop Surg"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1097\/00003086-199904000-00030","article-title":"Effect of pin location on stability of pelvic external fixation","volume":"361","author":"Kim","year":"1999","journal-title":"Clin Orthop Relat Res"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"S27","DOI":"10.1016\/S0020-1383(15)30008-5","article-title":"Minimally-invasive fixation for anterior pelvic ring disruptions","volume":"46","author":"Cole","year":"2015","journal-title":"Injury"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1302\/0301-620X.89B2.18551","article-title":"Percutaneous fixation of the pelvic ring: an update","author":"Giannoudis","year":"2007","journal-title":"J Bone Joint Surg Br"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1186\/s13018-018-1040-6","article-title":"Using the Starr frame and Da Vinci surgery system for pelvic fracture and sacral nerve injury","volume":"14","author":"Peng","year":"2019","journal-title":"J Orthop Surg Res"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"221","DOI":"10.1111\/os.13056","article-title":"Percutaneous robot-assisted versus freehand S2 iliosacral screw fixation in unstable posterior pelvic ring fracture","volume":"14","author":"Han","year":"2022","journal-title":"Orthop Surg"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"304","DOI":"10.1302\/0301-620X.71B2.2925751","article-title":"Grading the outcome of pelvic fractures","author":"Majeed","year":"1989","journal-title":"J Bone Joint Surg Br"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"372","DOI":"10.3760\/cma.j.cn115530-20220220-00100","article-title":"Intelligent robot-assisted minimally invasive reduction system for reduction of unstable pelvic fractures: a cadaveric study","volume":"24","author":"Zhao","year":"2022","journal-title":"Chin J Orthop Trauma"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1186\/s13018-022-03089-2","article-title":"Design and evaluation of an intelligent reduction robot system for the minimally invasive reduction in pelvic fractures","volume":"17","author":"Zhao","year":"2022","journal-title":"J Orthop Surg Res"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"4056","DOI":"10.1016\/j.injury.2022.11.001","article-title":"Intelligent robot-assisted minimally invasive reduction system for reduction of unstable pelvic fractures","volume":"53","author":"Zhao","year":"2022","journal-title":"Injury"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"1598","DOI":"10.3390\/jcm11061598","article-title":"Robot-assisted autonomous reduction of a displaced pelvic fracture: a case report and brief literature review","volume":"11","author":"Ge","year":"2022","journal-title":"Appl Sci"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"240","DOI":"10.19548\/j.2096-269x.2024.04.009","article-title":"Systematic review of classification methods and their consistency for pelvic fractures","volume":"9","author":"Chen","year":"2024","journal-title":"J Orthop Clin Res"},{"key":"ref22","first-page":"25","article-title":"The unstable pelvic fracture. Operative treatment","volume":"18","author":"Kellam","year":"1987","journal-title":"Orthop Clin North Am"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"1267","DOI":"10.1007\/s11548-020-02140-z","article-title":"Virtual reconstruction of unilateral pelvic fractures by using pelvic symmetry","volume":"15","author":"Ead","year":"2020","journal-title":"Int J Comput Assist Radiol Surg"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"100101","DOI":"10.1016\/j.medntd.2021.100101","article-title":"Experimental and finite element analysis studies of a reduction-force reducing traction method for pelvic fracture surgeries","volume":"13","author":"Liu","year":"2022","journal-title":"Med Novel Technol Dev"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1097\/00003086-198905000-00009","article-title":"Internal fixation of pelvic ring fractures","volume":"242","author":"Matta","year":"1989","journal-title":"Clin Orthop Relat Res"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1744048\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T12:17:41Z","timestamp":1771417061000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1744048\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,18]]},"references-count":25,"alternative-id":["10.3389\/fmed.2026.1744048"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1744048","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,18]]},"article-number":"1744048"}}