Combining robotics and 3D printing facilitates closed reduction of humeral shaft fractures using a minimally invasive plate as a reduction template: A proof-of-concept study

Dapeng Liu, Jinghao Liang, Hongju Yang
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Abstract

Background

Minimally invasive percutaneous plate osteosynthesis for humeral shaft fractures (HSFs) has limitations due to malreduction and radiation exposure. To address these limitations, we integrated robotics and 3D printing by incorporating plates as reduction templates.

Method

The innovative technology facilitated closed reduction of HSFs in the operating theatre using 18 models with cortical marking holes. The dataset of the precontoured plate was imported into 3D planning software for virtual fixation and screw path planning. The models were divided into half to simulate transverse fractures. During the operation, the software generated drilling trajectories for robot navigation, and precise plate installation achieved automatic fracture reduction.

Results

The evaluation results of reduction accuracy revealed variations in length, apposition, alignment, and rotation that meet the criteria for anatomic reduction. High interoperator reliabilities were observed for all parameters.

Conclusions

The proposed technology achieved anatomic reduction in simulated bones.

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结合机器人技术和 3D 打印技术,使用微创钢板作为还原模板,促进肱骨轴骨折的闭合还原:概念验证研究。
背景:微创经皮钢板骨合成术治疗肱骨轴骨折(HSFs)有其局限性,原因是钢板还原不良和辐射暴露。为了解决这些局限性,我们整合了机器人技术和 3D 打印技术,将钢板作为还原模板:方法:这项创新技术利用 18 个带有皮质标记孔的模型,在手术室内完成了 HSF 的闭合复位。预轮廓钢板的数据集被导入三维规划软件,用于虚拟固定和螺钉路径规划。模型被分成两半,以模拟横向骨折。在操作过程中,软件为机器人导航生成钻孔轨迹,钢板的精确安装实现了骨折的自动复位:结果:骨折复位精确度的评估结果显示,长度、位置、对齐和旋转的变化符合解剖复位的标准。所有参数的操作员间可靠性都很高:结论:所提出的技术实现了模拟骨骼的解剖复位。
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来源期刊
CiteScore
4.50
自引率
12.00%
发文量
131
审稿时长
6-12 weeks
期刊介绍: The International Journal of Medical Robotics and Computer Assisted Surgery provides a cross-disciplinary platform for presenting the latest developments in robotics and computer assisted technologies for medical applications. The journal publishes cutting-edge papers and expert reviews, complemented by commentaries, correspondence and conference highlights that stimulate discussion and exchange of ideas. Areas of interest include robotic surgery aids and systems, operative planning tools, medical imaging and visualisation, simulation and navigation, virtual reality, intuitive command and control systems, haptics and sensor technologies. In addition to research and surgical planning studies, the journal welcomes papers detailing clinical trials and applications of computer-assisted workflows and robotic systems in neurosurgery, urology, paediatric, orthopaedic, craniofacial, cardiovascular, thoraco-abdominal, musculoskeletal and visceral surgery. Articles providing critical analysis of clinical trials, assessment of the benefits and risks of the application of these technologies, commenting on ease of use, or addressing surgical education and training issues are also encouraged. The journal aims to foster a community that encompasses medical practitioners, researchers, and engineers and computer scientists developing robotic systems and computational tools in academic and commercial environments, with the intention of promoting and developing these exciting areas of medical technology.
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