A remote control robotic surgical system for femur shaft fracture reduction

摘要

Locked intramedullary nail fixation nowadays is the preferred treatment of femoral shaft fractures. However, in addition to its advantages, there are some drawbacks such as the frequent occurrence of malalign, and high radiation exposure, especially to the surgeon. Fracture reduction is a critical step in minimally invasive surgery of displaced femoral fracture treatment. We have developed a measuring system to obtain the forces required during the process of fracture reduction in previous study. The measurement and analysis of the reduction mechanical parameters provide basic foundations for the development of fracture reduction robot and procedure planning. This paper presents a novel cuff-type robot-assisted long bone fracture reduction system, with the significant features of teleoperation system. Skeletal traction and alignment for fracture reduction can be performed individually in the operation, which is a standard procedure for the surgeon in practice. Accordingly, the robot system consists of a distraction device to accomplish the pre-operative distraction, a cuff-type reduction unit to manipulate the proximal/distal fragments for alignment and a teleoperation system to complete the performance. Finally, experiments were performed to verify the reduction accuracy with long bone fracture models. The axial, lateral and vertical mean errors were 1.86mm, 1.48mm and 1.9mm, respectively, and their maximums were 2.5mm, 2.0mm and 2.6mm. The mean error of rotation was 2.1 °, and the maximums was 2.4 °. The experimental results show the effectiveness of the proposed robot-assisted fracture reduction system, and indicate the potential valuable for further research development.