Minimally invasive treatment of displaced femoral shaft fractures with a teleoperated robot-assisted surgical system

Zhu, Quanmin; Liang, Bin; Wang, Xingsong; Sun, Xiaogang; Wang, Liming

doi:10.1016/j.injury.2017.07.014

Cited by 14 publications

(8 citation statements)

References 22 publications

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“…Additionally, the structure of the device was complex, and the assembly was time consuming [9,10]. Zhu et al [20] developed a teleoperated robot-assisted surgical system for the minimally invasive treatment of displaced femoral shaft fractures, but it is still an experimental model, which is predictably expensive and not ready for practical use [21]. Therefore, given these technical difficulties, many surgeons continue to consider open reduction and internal fixation [22] but do not consider the advantages of IM nailing.…”

Section: Discussionmentioning

confidence: 99%

A novel closed reduction technique for treating femoral shaft fractures with intramedullary nails, haemostatic forceps and the lever principle

Shui

Yang

et al. 2021

BMC Musculoskelet Disord

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Background Faster, easier, more economical and more effective versions of the minimally invasive reduction procedure for femoral shaft fractures need to be developed for use by orthopaedic surgeons. In this study, a fracture table was used to restore limb length, and long, curved haemostatic forceps and the lever principle were utilized to achieve minimally invasive reduction and intramedullary nail fixation of femoral shaft fractures. Methods A retrospective analysis involving 20 patients with femoral shaft fractures reduced with a fracture table; long, curved haemostatic forceps; and the lever principle was conducted. The operative effect was evaluated on the basis of the operative time, reduction time, fluoroscopy time, and intraoperative blood loss. Results All 20 cases were reduced in a closed fashion, and no conversions to open reduction were needed. The average operative time and fracture reduction time for all patients were 69.1 ± 13.5 min (range, 50–100 min) and 6.7 ± 1.9 min (range, 3–10 min), respectively. The fluoroscopy exposure time during the reduction process was 5–15 s, with an average time of 8.7 ± 2.7 s. The average intraoperative blood loss was 73.5 ± 22.5 mL (range, 50–150 mL). The patients exhibited excellent alignment in the injured limb after intramedullary nailing. Seventeen patients successfully completed a follow-up after fracture healing. The healing time ranged from 4 to 6 months. Conclusions Displaced femoral shaft fractures in adults can be treated by a labour-saving lever technique involving fragments, 2 haemostatic forceps and soft tissue envelope-assisted closed reduction and intramedullary nail fixation. This technique is easy to perform; reduces blood loss, the fluoroscopy time and the surgical time for intraoperative reduction; and leads to excellent fracture healing.

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Section: Discussionmentioning

confidence: 99%

A novel closed reduction technique for treating femoral shaft fractures with intramedullary nails, haemostatic forceps and the lever principle

Shui

Yang

et al. 2021

BMC Musculoskelet Disord

View full text Add to dashboard Cite

show abstract

“…Additionally, the structure of the device was complex, and the assembly was time consuming [8,9]. Zhu et al [15] developed a teleoperated robot-assisted surgical system for the minimally invasive treatment of displaced femoral shaft fractures, but it is still an experimental model, which is predictably expensive and not ready for practical use [16]. Therefore, because of these technical di culties, many surgeons continue to consider open reduction and internal xation [17] but do not consider the advantages of IM nailing.…”

Section: Various Closed Reduction Devices Have Been Developed For Thementioning

confidence: 99%

A Novel Closed Reduction Technique for Treating Femoral Shaft Fractures With Intramedullary Nails, Haemostatic Forceps and the Lever Principal

Shui

Yang²,

et al. 2020

Preprint

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Background: Faster, easier, more economical and more effective versions of the minimally invasive reduction procedure for femoral shaft fractures need to be developed for use by orthopaedic surgeons. In this study, a fracture table was used to restore limb length, and long, curved haemostatic forceps and the lever principle were utilized to achieve minimally invasive reduction and intramedullary nail fixation of femoral shaft fractures.Methods: A retrospective analysis involving 20 patients with femoral shaft fractures reduced with a fracture table; long, curved haemostatic forceps; and the lever principle was conducted. The operative effect was evaluated on the basis of the operative time, reduction time, fluoroscopy time, and intraoperative blood loss.Results: All 20 cases were reduced in a closed fashion, and no conversions to open reduction were needed. The average operative time and fracture reduction time for all patients were 69.1±13.5 minutes (range, 50–100 minutes) and 6.7±1.9 minutes (range, 3–10 minutes). The fluoroscopy exposure time during the reduction process was 5–15 seconds, with an average time of 8.7±2.7 seconds. The average intraoperative blood loss was 73.5±22.5 mL (range, 50–150 mL). The patients exhibited excellent alignment in the injured limb after intramedullary nailing. Seventeen patients successfully completed a follow-up after fracture healing. The healing time ranged from 4 to 6 months.Conclusions: Displaced femoral shaft fractures in adults can be treated by a labour-saving lever technique involving fragments, 2 haemostatic forceps and soft tissue envelope-assisted closed reduction and intramedullary nail fixation. This technique is easy to perform; reduces blood loss, the fluoroscopy time and the surgical time for intraoperative reduction; and leads to excellent fracture healing.

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“…In order to prevent the robot from moving too fast, the velocity regulation of the LGC controller has been introduced at every sampling time ΔT, as shown in Figure 5 . If the distance |ΔX| between the current pose and the target pose of the distal segment is larger than |V vf |·ΔT, the guiding speed is regulated to maintain a predetermined constant speed |V vf |, as shown in Equation 10. If |ΔX| is less than |V vf |·ΔT, the robot's pose is updated to the target pose, as shown in Equation 11.…”

Section: Linear Guidance Constraints For Fracture Reduction Surgerymentioning

confidence: 99%

“…3 To solve these issues, robot-assisted fracture reduction (RAFR) systems have been recently developed. [4][5][6][7][8][9][10] Most of these systems are consisted of robot systems, navigations, and medical devices, and they are generally operated remotely. [4][5][6][7][8][9] To alleviate the surgeon's control burden, some systems are developed to operate automatically, so that the robot follows the fracture reduction path that is planned based on a 3D bone image model using their anatomical knowledge and experience pre-or intra-operatively.…”

Section: Introductionmentioning

confidence: 99%

Hands‐on robot‐assisted fracture reduction system guided by a linear guidance constraints controller using a pre‐operatively planned goal pose

Kim

2018

Robotics Computer Surgery

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Background:In robot-assisted fracture reduction systems, the fine alignment of the fractured bone and its path planning are still of issues that need to be resolved. Methods:A novel linear guidance constraints (LGC) controller guides a robot along the shortest path to align a distal fracture segment and a proximal one. In addition, the surgeon can modify the path whenever s/he wants. Results:When the LGC controller is used in the experiment on a femoral bone model with simulated muscles, the fracture reduction time was measured to be 35.6 ± 16.4 seconds, while the position and the angle errors were 0.41 ± 0.61 mm, and 0.22 ± 0.80°, respectively. The proposed controller reduced the reduction time by 78.1%, the translational error by 91.6%, and the angular error by 95.4%, compared with the cases without the LGC controller. Conclusions:It was proven that the proposed scheme reduced the reduction time and the pose error of the fracture alignment, and that it is effective to alleviate the maneuvering load.

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Minimally invasive treatment of displaced femoral shaft fractures with a teleoperated robot-assisted surgical system

Cited by 14 publications

References 22 publications

A novel closed reduction technique for treating femoral shaft fractures with intramedullary nails, haemostatic forceps and the lever principle

A novel closed reduction technique for treating femoral shaft fractures with intramedullary nails, haemostatic forceps and the lever principle

A Novel Closed Reduction Technique for Treating Femoral Shaft Fractures With Intramedullary Nails, Haemostatic Forceps and the Lever Principal

Hands‐on robot‐assisted fracture reduction system guided by a linear guidance constraints controller using a pre‐operatively planned goal pose

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