Force–torque intraoperative measurements for femoral shaft fracture reduction

Abstract

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.

Experimental measurement of force, torque control and vibration absorber system for intraoperative tele-operated robotic-assisted femoral shaft drilling using air-controlled soft balloon damper

“…The simulated human bone and muscles used for this experiment had very similar physical and material characteristics to real human bone and muscles. The muscles were made up of flexible rubber tube and silicone, since silicone has a similar appearance to human body, especially in terms of stiffness (Lee et al, 2012; Zhu et al, 2016). In order to experimentally illustrate force, torque control and vibration reduction caused by the dynamic components of the cutting force, another important parameter gives some vital ideas about the relative position between the drill and the femur bone (Orelaja et al, 2020b).…”

“…All the acquisition signals from the sensors arrangement provides the core module of our force, torque measurement, control and vibration reduction system; we employed well grooved and evenly distributed architecture to ensure reliability and quality of our data, especially on the regulation of the balloon pressure (Rashid et al, 2014). This distributed architecture provides enormous advantages including real-time monitoring and less cost of maintenance through the incorporation of small subsystems, which reduces the overall cost of component repair and replacement (Zhu et al, 2016). The data acquisition module of our system used a series of EMS359 data acquisition that has the interfaced with a personal computer.…”

“…Consequently, this results in a change in the natural frequency and mode of the bone (Alizad et al, 2006). Optimum safety, operational time reduction and perfect drilling process are guaranteed when vibration and cutting forces are controlled or reduced (Zhu et al, 2016). According to Dai et al (2013) and Coulson et al (2008) they conducted an experiment using direct measurement of vibration signal on the bone while drilling with the use of laser displacement sensor based on triangulation.…”

Fuzzy Adaptive Sliding Mode Impedance Control of Fracture Reduction Robot

“…At present, the research on reduction force control of reduction robot mainly focuses on the measurement of reduction force [6] and the mathematical modeling of muscle force [7] to obtain accurate reduction force. Georgilas et al clinically measured the reduction force of femoral fractures in patients as high as 604.53 N [8].…”

Design of a vibration damping robot and force evaluation in intraoperative robotic‐assisted femoral shaft repair using a modified soft damper

“…However, this depends on bone density, which therefore resulted to change in the natural frequency and mode of the bone. 15 A dynamic model of the system was also created, and experiments were carried out to determine the amount of drill forces and vibration reduction. The concept introduced in this work fills in the gap yet to be addressed in the literature on bone drilling techniques, where it is shown that bone repair using drills can be achieved successfully by reducing the forces acting on it and the resulting vibration simultaneously, which leads to a successful vibration reduction with promising clinical application.…”