Robot Assisted Fracture Reduction

Westphal, Ralf; Gösling, Thomas; Oszwald, Markus; Bredow, Jan; Klepzig, Daniel; Winkelbach, Simon; Hüfner, T.; Krettek, Christian; Wahl, Friedrich M.

doi:10.1007/978-3-540-77457-0_15

Cited by 22 publications

(26 citation statements)

References 11 publications

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“…[21][22][23][24] The technique has the overall aim of improving reduction accuracy and of reducing the incidence of femoral malrotation. 21,25,26 Given that this system includes features of telemanipulated and hands-on robotic systems, 27 achieving a reliable and user-friendly human-robot interface is an important part of this project.…”

Section: Introductionmentioning

confidence: 99%

Improving the human–robot interface for telemanipulated robotic long bone fracture reduction: Joystick device vs. haptic manipulator

Suero

Hartung

Westphal

et al. 2017

Robotics Computer Surgery

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Objectives: Intramedullary nailing is the treatment of choice for femoral shaft fractures.However, there are several problems associated with the technique, e.g. high radiation exposure and rotational malalignment. Experimental robotic assistance has been introduced to improve the quality of the reduction and to reduce the incidence of rotational malalignment. In the current study, we compare two devices for control of the fracture fragments during telemanipulated reduction.Methods: Ten male and ten female subjects were asked to participate as examiners in this experiment. A computer program was developed to render and manipulate CT-based renderings of femur fracture bone fragments. The user could manipulate the fragments using either a simple joystick device or a haptic manipulator. Each examiner performed telemanipulated reduction of 10 virtual fracture models of varying difficulty with each device (five in a 'training phase' and five in a 'testing phase'). Mixed models were used to test whether using the haptic device improved alignment accuracy and improved reduction times compared to using a joystick.Results: Reduction accuracy was not significantly different between devices in either the training phase or the testing phase (P > 0.05). Reduction time was significantly higher for the Phantom device than for the Joystick in the training phase (P < 0.0001), but it was no different in the testing phase (P = 0.865). High spatial ability with electronics had a significant effect on the alignment of fracture reduction and time to reduction. Conclusions:The Joystick and the Phantom devices resulted in similarly accurate reductions, with the Joystick having an easier learning curve. The Phantom device offered no advantage over the Joystick for fracture telemanipulation. Considering the high cost of the Phantom device and the lack of a demonstrable advantage over the Joystick, its use is not justified for implementation in a fracture telemanipulation workflow. The Joystick remains as a low-cost and effective device for developing 3D fracture telemanipulation techniques.

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Section: Introductionmentioning

confidence: 99%

Improving the human–robot interface for telemanipulated robotic long bone fracture reduction: Joystick device vs. haptic manipulator

Suero

Hartung

Westphal

et al. 2017

Robotics Computer Surgery

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“…For example, the intraoperative X-ray guidance could irradiate patients and surgeons who frequently perform such surgeries. Additionally, the twodimensional X-ray data lack information in the depth direction, which leads to rotational errors [3,4].…”

Section: Introductionmentioning

confidence: 99%

Robot-musculoskeletal dynamic biomechanical model in robot-assisted diaphyseal fracture reduction

Wang

et al. 2015

BME

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Abstract.A number of issues that exist in common fracture reduction surgeries can be mitigated by robot-assisted fracture reduction. However, the safety of patients and the performance of the robot, which are closely related to the muscle forces, are important indexes that restrict the development of robots. Though researchers have done a great deal of work on the biomechanics of the musculoskeletal system, the dynamics of the musculoskeletal system, particularly the aspects related to the function of the robot, is not well understood. For this reason, we represent the complex biological system by establishing a dynamic biomechanical model based on the Hill muscle model and the Kane method for the robot that we have developed and the musculoskeletal system. We analyzed the relationship between the motion and force of the bone fragments and the robot during a simulation of a robot-assisted fracture reduction. The influence of the muscle force on the robot system was predicted and managed. The simulation results provide a basis for a fracture reduction path plan that ensures patient safety and a useful reference for the mechanical design of the robot.

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“…Westphal et al [7] developed a surgical telemanipulator based on a large-scale industrial robot RX90 for femur shaft fracture reduction. S. Warisawa et al [11] used the robot to assist surgery with tractive reduction based on the photoelectric tracking navigation, aiming at the femur and the femoral neck fracture.…”

Section: Introductionmentioning

confidence: 99%

Accuracy Analysis of a Robot System for Closed Diaphyseal Fracture Reduction

Wang

et al. 2014

International Journal of Advanced Robotic Systems

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We have developed a robot system for closed diaphyseal fracture reduction. Because accuracy is essential for the treatment effects of the robot system and for the safety of both the patients and surgeons, we analysed accuracy in a systematic way. Both the structure of the robot and the operation procedure are described. Using the transfer model of errors in series and the error differential solving method for parallel mechanisms, an error model was established, and the main influencing factors of errors were considered. The Monte Carlo method was used to perform the simulation based on the error model. Experiments of image registration, of the mechanism and of the whole robot system were tested in different aspects to verify that the results of the simulation are correct. The system accuracy was compared with clinical standards to show that the robot system fulfilled the requirements for closed diaphyseal fracture reduction. The accuracy analysis method also provides an efficient path for other medical robots.

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Robot Assisted Fracture Reduction

Cited by 22 publications

References 11 publications

Improving the human–robot interface for telemanipulated robotic long bone fracture reduction: Joystick device vs. haptic manipulator

Improving the human–robot interface for telemanipulated robotic long bone fracture reduction: Joystick device vs. haptic manipulator

Robot-musculoskeletal dynamic biomechanical model in robot-assisted diaphyseal fracture reduction

Accuracy Analysis of a Robot System for Closed Diaphyseal Fracture Reduction

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