TiRobot-assisted cannulated screw fixation for calcaneal fractures: a meta-analysis of surgical trauma, anatomical restoration, and functional recovery.

Background: TiRobot-assisted cannulated screw fixation may improve surgical precision and clinical outcomes in calcaneal fractures. This meta-analysis evaluated its effects on surgical trauma, anatomical restoration, functional recovery, and complications compared with conventional fixation. Methods: PubMed, Embase, Web of Science, Cochrane Library, and CNKI were searched from inception to April 2026. Comparative studies evaluating TiRobot-assisted versus conventional fixation for calcaneal fractures were included. Pooled mean differences (MDs) or odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. Results: Nine studies involving 509 patients were included. Operative time was comparable between groups (MD = -0.75 min). TiRobot-assisted fixation reduced intraoperative blood loss (MD = -28.22 mL) and improved calcaneal anatomical restoration, including calcaneal height (MD = 1.88 mm), Böhler angle (MD = 1.50°), and Gissane angle (MD = 5.00°). Patients treated with TiRobot assistance showed lower postoperative VAS scores (MD = -0.84 points), higher AOFAS ankle-hindfoot scores (MD = 4.21 points), and fewer overall complications (OR = 0.17). Conclusions: TiRobot-assisted cannulated screw fixation provides measurable improvements in surgical trauma, anatomical reconstruction, early pain relief, functional recovery, and postoperative safety compared with conventional fixation. Further multicenter randomized controlled trials with long-term follow-up are required to confirm these findings.