Abstract:

BACKGROUND: Robot-assisted surgery is the future of femoral fracture treatment. It coud create a real minimally invasive fracture manipulation, which is the one-time, single-way, fine-tune gentle reduction. It can greatly decrease the systemic and local damage of fracture manipulation.
OBJECTIVE: To report a new system of robot-assisted surgery for femoral fracture and the preliminary experimental results.
METHODS: The study was accomplished in Hannvoer Medical University in Germany. Human femoral cadavers and navigation system and Stäubli RX 90CR robot system were employed, dynamic reference bases (DRB) was mounted on the distal and proximal femur and the robotic arm as well to record the initial spatial relative relationship. The femur was fractured by Zwick/Roell machine, the 3D fluoroscopy imaging of the fracture area was created by three-dimensional fluoroscopy, and the fracture fragments were visualized on the screen, with the navigation system, the fracture was reduced by the robot arm based on the visual reality. The accuracy of the reduction result in terms of lateral displacement and angulation and malrotation were measured.
RESULTS AND CONCLUSION: This robot-assisted fracture reduction system worked well. In simple fracture, the reduction time was 4 minutes and 34 seconds on the average, the mean lateral displacement was 1.61 mm, the mean angle error was 1.42°, and the rotation error was 1.37°. The rotation error was still below 4° for complex fractures. This solution of robotic fracture reduction is promising. It seems to be a universal platform in the research of robotic fracture treatment.