Department of Orthopedics, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing, 100853, China.
Department of Biomedical Engineering, National University of Singapore, Singapore, Singapore.
Ann Biomed Eng. 2020 Jan;48(1):203-224. doi: 10.1007/s10439-019-02332-y. Epub 2019 Jul 29.
Robots in orthopedic surgery have been developed rapidly for decades and bring significant benefits to the patients and healthcare providers. However, robotics in fracture reduction remains at the infant stage. As essential components of the current robotic system, external fixators were used in fracture reduction, including the unilateral and Ilizarov-like ring fixators. With emerging of the industrial robots and mechanical arms, their sterilized variants were developed as the serial robots, including the traction device and robotic arm, for fracture reduction. Besides, parallel robots (e.g., Gough-Stewart platform) were devised for lower extremity traction and fracture reduction. After combining the advantages of the serial and parallel mechanisms, hybrid robots can fulfill specific clinical requirements (e.g., the joint fracture, including multiple major fragments). Furthermore, with the aid of intra-operative navigation systems, fracture reduction can be performed under real-time guidance. The paper presents a comprehensive overview of the advancement of the robots in fracture reduction and evaluates research challenges and future perspectives, including ergonomic and economic issues, operation time, artificial realities and intelligence, and telesurgery.
几十年来，骨科机器人发展迅速，为患者和医疗保健提供者带来了显著的益处。然而，骨折复位机器人仍处于起步阶段。作为当前机器人系统的基本组成部分，外固定器被用于骨折复位，包括单边和伊里扎洛夫式环固定器。随着工业机器人和机械臂的出现，它们的无菌变体被开发为串联机器人，包括牵引装置和机械臂，用于骨折复位。此外，还设计了并联机器人（例如，Gough-Stewart 平台）用于下肢牵引和骨折复位。在结合串联和并联机构的优点后，混合机器人可以满足特定的临床需求（例如，关节骨折，包括多个主要碎片）。此外，借助术中导航系统，可以在实时引导下进行骨折复位。本文全面介绍了骨折复位机器人的研究进展，并评估了研究挑战和未来展望，包括人机工程学和经济问题、操作时间、人工现实和智能以及远程手术。
