Robotized access to the medullary cavity for intramedullary nailing of the femur

Technology and Health Care : Official Journal of the European Society for Engineering and Medicine
Markus OszwaldThomas Gösling

Abstract

The insertion site for an antegrade femoral intramedullary nail in the treatment of a femoral shaft fracture has traditionally been performed using a free-hand technique. An inappropriate starting point can result in suboptimal nail insertion leading to malreduction, or iatrogenic fracture. Furthermore, repeated attempts to establish the optimal starting point can cause additional soft tissue trauma and radiation exposure. In the following study we compared a robot-guided technique with the standard free-hand technique for establishing the entry point of an antegrade femoral nail. We hypothesized that the robot-guided technique is more reliable and efficient. A custom-made drill-guide was mounted onto the arm of an industrial robot. Two orthogonal fluoroscopic images were acquired from the proximal femur of five cadaveric human specimens. Images were processed with a special software in order to create an enhanced contour-recognition map from which the bone axes were automatically calculated. The drilling trajectory was computed along the extension of the bone-axis. The robot then moved the drill-guide on this trajectory toward the entry point. The drilling was then performed by the surgeon. In the control group, five cadaveric...Continue Reading

Citations

Sep 11, 2017·Journal of Robotic Surgery·Eduardo M SueroTimo Stuebig
May 3, 2018·Annals of the Royal College of Surgeons of England·Karthik Karuppiah, Joydeep Sinha
Mar 5, 2015·The Bone & Joint Journal·K KarthikJ Sinha
Jul 31, 2019·Annals of Biomedical Engineering·Jing-Xin ZhaoPei-Fu Tang
May 26, 2017·The International Journal of Medical Robotics + Computer Assisted Surgery : MRCAS·Martin PanzicaTimo Stuebig
Sep 28, 2017·The International Journal of Medical Robotics + Computer Assisted Surgery : MRCAS·Eduardo M SueroTimo Stuebig
Sep 26, 2017·The International Journal of Medical Robotics + Computer Assisted Surgery : MRCAS·Eduardo M SueroTimo Stuebig

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