Artificial Intelligence-Assisted vs Surgeon-Directed Screw Planning in Robotic Femoral Neck Fracture Surgery

The trajectory for screw placement during femoral neck fracture fixation will be guided by an AI algorithm based on intraoperative X-ray imaging. The system will automatically suggest the screw entry point and trajectory on the robotic navigation platform. The surgeon will proceed with the operation after confirming the feasibility of the AI-generated plan. In principle, surgeons are advised not to modify the AI-recommended trajectory unless necessary, to preserve the independent evaluative value of the AI-assisted plan. If significant disagreement arises between the surgeon's judgment and the AI-recommended trajectory, a third-party orthopedic specialist-blinded to group allocation-will conduct an independent postoperative assessment of the screw placement's appropriateness and accuracy.

The screw trajectory will be entirely determined manually by the operating surgeon, based on personal experience and under guidance from the robotic navigation system and intraoperative fluoroscopy, without reliance on any AI recommendation module.