ORIGINAL RESEARCH article
Front. Surg.
Sec. Orthopedic Surgery
Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1594928
This article is part of the Research TopicSystems Immunology and Computational Omics for Transformative MedicineView all 8 articles
Assessing Surgical Trauma in Robot-Assisted Pelvic Fracture Fixation: The Role 1 of the Systemic Immune-Inflammatory Index (SII)
Provisionally accepted
- Affiliated Hospital of Hebei University of Engineering, Handan, China
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Objective: This study aims to evaluate the association between the Systemic 10 Immune-Inflammatory Index (SII) and the degree of surgical invasiveness in patients 11 undergoing robot-assisted fixation for anterior pelvic ring fractures. Methods: This 12 study enrolled patients aged 18–80 years with anterior pelvic ring fractures who 13 underwent INFIX internal fixation, either with or without robotic assistance, between 14 July 2022 and December 2023. Participants were categorized into two groups based 15 on the use of robot-assisted techniques. Exclusion criteria included the presence of 16 multiple fractures requiring additional internal fixation, pre-existing infections, or 17 underlying conditions that could influence inflammatory blood markers. Operative 18 duration, intraoperative blood loss, and incidence of lateral femoral cutaneous nerve 19 (LFCN) injury were documented. The SII was assessed both pre-and postoperatively. 20 Statistical analyses were performed using t-tests. Receiver operating characteristic 21 (ROC) curves were generated to evaluate the predictive performance of SII regarding 22 surgical invasiveness, with optimal cutoff values determined using the Youden index. 23 Results: A total of 41 patients were included in the study. No significant differences 24 in gender or age were observed between the robot-assisted and non-robot-assisted 25 groups. Compared to the non-robot-assisted group, the robot-assisted group 26 demonstrated significantly shorter operative duration, reduced intraoperative bleeding, 27 and a lower incidence of lateral femoral cutaneous nerve (LFCN) palsy ( P < 0.05). 28 Additionally, the postoperative SII was significantly lower in the robot-assisted group 29 (P < 0.05). Receiver operating characteristic (ROC) curve analysis revealed that 30 postoperative SII exhibited a predictive capability for surgical invasiveness, with an 31 optimal cutoff value of 745.15 (AUC=0.81; sensitivity, 75%; specificity, 83.3%). 32 Conclusion: The findings suggest that the postoperative SII may serve as a valuable 33 biomarker reflecting the degree of surgical invasiveness associated with robot-assisted 34 or conventional INFIX procedures for anterior pelvic ring fractures. A postoperative 35 SII value exceeding 745.15 demonstrates promising predictive utility for elevated 36 surgical trauma, with a specificity of 83.3% and sensitivity of 75%.
Keywords: Robot-assisted, Systemic immune-inflammatory index, Infix, Anteriorsubcutaneous internal pelvic fixation, Pelvic anterior ring fracture
Received: 18 Mar 2025; Accepted: 03 Sep 2025.
Copyright: © 2025 Zhang, Niu, Chen, Yang, He and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yong-tao Zhang, Affiliated Hospital of Hebei University of Engineering, Handan, China
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