Advancing computer-assisted orthopaedic surgery using a hexapod device for closed diaphyseal fracture reduction

Du, Hong; Hu, Lei; Li, Changsheng; Wang, Tianmiao; Zhao, Lu; Li, Yang; Mao, Zhi; Liu, Daohong; Zhang, Lining; He, Chunqing; Zhang, Licheng; Hou, Hongping; Tang, Peifu

doi:10.1002/rcs.1614

Cited by 54 publications

(35 citation statements)

References 24 publications

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“…However, the endeffector of their robot-assisted system is rigidly fixed to the distal fracture fragment via Schanz screws, which causes additional injury to patients and increases the difficulty of IM nail implantation. Wang et al [19][20][21] developed a parallel robot for closed diaphyseal shaft fracture reduction based on the Stewart platform. The robot includes two ring plates, a mobile and a ground plate, connected by six linear actuators, with each actuator controlled via independent motors.…”

Section: Discussion and Future Workmentioning

confidence: 99%

Force–torque intraoperative measurements for femoral shaft fracture reduction

Zhu

Liang

Wang

et al. 2016

Computer Assisted Surgery

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Background: The minimally invasive technique of closed intramedullary (IM) nailing fixation is currently considered the standard of treatment for the operative management of displaced traumatic fractures of the femur, with fracture reduction and repositioning being the first and most important step of the procedure. Skeletal-muscle traction and alignment of the fracture fragments are always performed as individual components of the reduction and repositioning phase of the procedure. Methods: As use of high traction force and repositioning forces and torques can cause additional soft tissue injury, we developed a sensor-based system to monitor these forces and torques during the treatment of diaphyseal fractures of the femur, including the monitoring of traction forces during the entire procedure, from reduction to IM nail implantation and fixation. Results: Based on a local coordinate system localized at the center of the fracture, maximum forces of 203 N along the medial-lateral (X) axis, 517 N along the anterior-posterior (Y) axis and 505 N along the shaft of the femur (Z-axis) were identified, with maximum torques of 16.4 Nm calculated around Y-axis and 38.3 Nm around X-axis. The pressure between the counteraction post and the perineum was also recorded, with magnitudes as high as 523 N being recorded. Excessive forces were identified and the difference in force-torque magnitudes during different stages of the reduction and fixation procedure were calculated. Conclusion: The measurement system provides surgeons with real-time information which can assist them in performing effective repositioning of fracture fragments within safe margins of applied forces and torques.

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Section: Discussion and Future Workmentioning

confidence: 99%

Force–torque intraoperative measurements for femoral shaft fracture reduction

Zhu

Liang

Wang

et al. 2016

Computer Assisted Surgery

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“…Employing 3D imaging and surgical navigation techniques in combination with a robotassisted reduction procedure to overcome mal-alignment fracture reduction and minimized high x-ray exposures especially for operating team [7]. A new reduction strategy introduced by modification the hexapod computer-assisted fracture reduction system which is detachable, flexible and more precise in coordinate transformations used for closed diaphyseal fracture reduction [8]. A robotic system with 6 d.o.f mobility applied for home positioning of femoral shaft fracture based on Stewart platform [9].…”

Section: Introductionmentioning

confidence: 99%

Integration of computer-assisted fracture reduction system and a hybrid 3-DOF-RPS mechanism for assisting the orthopedic surgery

Irwansyah

Phu

Lai³

et al. 2018

IOP Conf. Ser.: Mater. Sci. Eng.

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Abstract. In this paper, we present study to integrate virtual fracture bone reduction simulation tool with a novel hybrid 3-DOF-RPS external fixator to relocate back bone fragments into their anatomically original position. A 3D model of fractured bone was reconstructed and manipulated using 3D design and modeling software, PhysiGuide. The virtual reduction system was applied to reduce a bilateral femoral shaft fracture type 32-A3. Measurement data from fracture reduction and fixation stages were implemented to manipulate the manipulator pose in patient's clinical case. The experimental result presents that by merging both of those techniques will give more possibilities to reduce virtual bone reduction time, improve facial and shortest healing treatment. IntroductionUtilization the computer-assisted or robotic surgery technology for enhancing orthopedic procedure is still not mature yet. It needs more evident for patients and surgeons to improve the uncertainty and make them sure that those of assisted-technology can provide accurate, predictable and safe treatment. At least two decades research in Computer-Aided Orthopaedic Surgery (CAOS) and Orthopaedic Robotics (CAOR) have happened in design and development level but only a few of them are presently being allowed for clinical trials. In orthopedic clinical practice, complicated bone deformities treatment and unreduced fractures are always problematic issues. In this study, the combination of virtual fracture reduction with a robotic-assisted reduction is proposed to solve those problems. Currently, we have built an integrated preoperative simulation system for orthopedic surgery and have been used as preoperative planning tool for a surgeon to solve clinical cases of bone fracture reduction and implant placement. The system is operated in a PC based environment that integrates the virtual surgery tools in single computer program package, making it easy to implement in clinical applications [1][2]. The aims of our research to study integration of computer-assisted fracture reduction and robotic system. Even though computerassisted fracture reduction have been developed by several researchers with different level of accuracies, we explore beneficity merging both of cutting-edge-technology. A 3D model of fractured bone is generate directly from a stacks of CT images, segmented in multi region, and virtually reduce and stabilize. A computer-integrated orthopedic system, called FRACAS, was develop for deal with long bone fractures. It replace to use fluoroscopic images to virtual reality display of 3D bone models [3]. A 3D visualization tool was developed to generate a realistic model of the bone-fixator system. The visualization tool has improved the current software to provide a realistic depiction of the treatment procedure [4]. Integrating surgeon instructed, image-guided and robot-assisted applied to reposition long bone fracture. A robotic solution exists to solve the problems of manipulating and reducing long bone

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“…Figure 1 illustrates the system used for performing lone bone fracture reduction surgery. The critical components are the operation bed, fracture reduction robot (6 degrees of freedom (DOF) parallel robot), and the optical tracking system (Hybrid Polaris Spectra, Northern Digital Inc, Canada) [7][8][9]. The hand-eye calibration was performed before the operation, and it was used to determine the spatial relationship between the TCS of the reduction robot and the marker coordinate system (MCS) on the platform.…”

Section: Introductionmentioning

confidence: 99%

A new hand-eye calibration approach for fracture reduction robot

Wang

Tang

et al. 2017

Computer Assisted Surgery

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Objective: The hand-eye calibration is used to determine the transformation between the end-effector and the camera marker of the robot. But the robot movement in traditional method would be time-consuming, inaccurate and even unavailable in some conditions. The method presented in this article can complete the calibration without any movement and is more suitable in clinical applications. Methods: Instead of solving the classic non-linear equation AX ¼ XB, we collected the points on X and Y axes of the tool coordinate system (TCS) with the visual probe and fitted them using the singular value decomposition algorithm (SVD). Then, the transformation was obtained with the data of the tool center point (TCP). A comparison test was conducted to verify the performance of the method. Results: The average translation error and orientation error of the new method are 0.12 ± 0.122 mm and 0.18 ± 0.112 respectively, while they are 0.357 ± 0.347 mm and 0.416 ± 0.234 correspondingly in the traditional method. Conclusions: The high accuracy of the method indicates that it is a good candidate for medical robots, which usually need to work in a sterile environment.

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Advancing computer-assisted orthopaedic surgery using a hexapod device for closed diaphyseal fracture reduction

Abstract: Our new reduction system described here is detachable, flexible and more precise in coordinate transformations. The detachable, modular design will allow for more analogous applications in the future. Copyright © 2014 John Wiley & Sons, Ltd.

Cited by 54 publications

References 24 publications

Force–torque intraoperative measurements for femoral shaft fracture reduction

Force–torque intraoperative measurements for femoral shaft fracture reduction

Integration of computer-assisted fracture reduction system and a hybrid 3-DOF-RPS mechanism for assisting the orthopedic surgery

A new hand-eye calibration approach for fracture reduction robot

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