Trauma Department, Hannover Medical School, Hannover, Germany.
Institute for Robotics and Process Control, Braunschweig University of Technology, Germany.
Int J Med Robot. 2017 Dec;13(4). doi: 10.1002/rcs.1831. Epub 2017 May 23.
Interlocked intramedullary nailing is the treatment of choice for femoral shaft fractures. However, distal locking is a technically challenging part of the procedure that can result in distal femoral malrotation and high radiation exposure. We have tested a robotic procedure for robotic distal locking based on the computation of a drilling trajectory on two calibrated fluoroscopic images. Twenty distal holes were attempted in ten cadaveric femur specimens. Successful screw hole drilling was achieved at the first attempt in each of the ten specimens (20 drill holes in total). No failures were recorded. The average total number of images needed was 6.5 +/- 3.6. The average computation time was 16.5+/- 16.0 seconds. Robotic distal locking was feasible in this test and can be integrated into a fully robotic intramedullary nailing procedure.
交锁髓内钉是治疗股骨干骨折的首选方法。然而，远端锁定是该手术具有挑战性的技术部分，可能导致股骨远端旋转移位和高辐射暴露。我们已经测试了一种基于在两个校准的荧光透视图像上计算钻孔轨迹的机器人远端锁定机器人程序。在十个尸体股骨标本中尝试了二十个远端孔。在十个标本中的每一个标本中都成功地进行了第一次尝试的螺钉孔钻孔（总共 20 个钻孔）。没有记录到失败。平均需要的总图像数量为 6.5 +/- 3.6。平均计算时间为 16.5+/- 16.0 秒。在这项测试中，机器人远端锁定是可行的，可以集成到全机器人髓内钉手术中。
