Zha Qing, Xu Zeou, Yang Hongbo, Zhang Guodong, Cai Xuefeng, Zhang Wanlin, Liu Yujiang, Shen Xiaofeng, Li Yuwei
School of Biomedical Engineering (Suzhou), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.
Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Science, Suzhou, China.
Front Bioeng Biotechnol. 2024 Jan 10;11:1342229. doi: 10.3389/fbioe.2023.1342229. eCollection 2023.
Closed reduction is the preferred treatment for distal radius fractures. However, it requires a multiple experienced medical staff and manually maintaining stable traction is difficult. Additionally, doctors cannot assess the reduction status of a fracture in real-time through radiographic images, which may lead to improper reduction. Furthermore, post-fracture complications such as joint adhesion, stiffness, and impaired mobility pose a challenge for the doctors. So it is necessary to optimize the treatment process of the distal radius fracture through technological means. A robot-assisted closed reduction and rehabilitation system, which could assist doctors throughout the entire process of reduction, fixation, and rehabilitation of distal radius fractures, was developed. A mechanical system, composed of two grippers and a cooperative robotic arm, was used to grasp and tract the affected limb. A doctor controlled the robot through a joystick console and Windows application program. A biplane radiographic device was integrated into the system, which is not only convenient for doctors to view radiographic images of the fracture at any time but also for them to select the rotation axis of the wrist on the images before reduction and rehabilitation. Important information including the anteroposterior and lateral radiographic data and force and position parameters during the reduction and rehabilitation process were displayed on a graphic user interface. Experimental results showed that the proposed robotic system can meet the technical requirements for the reduction and rehabilitation of distal radius fractures, all the rotation angles could be achieved, a maximum force of more than 50 N could be achieved in all traction directions, and the error in selecting the wrist joint rotation axis line using radiographic images was less than 5 mm. The developed robot-assisted system was shown to be suitable for closed reduction and rehabilitation of distal radius fractures, contributing a potential improvement in the quality of the procedures.
闭合复位是桡骨远端骨折的首选治疗方法。然而,这需要多名经验丰富的医护人员,且手动维持稳定牵引较为困难。此外,医生无法通过X线图像实时评估骨折的复位情况,这可能导致复位不当。再者,骨折后的并发症,如关节粘连、僵硬和活动能力受损,给医生带来了挑战。因此,有必要通过技术手段优化桡骨远端骨折的治疗过程。研发了一种机器人辅助闭合复位与康复系统,该系统可在桡骨远端骨折的复位、固定和康复全过程中协助医生。一个由两个夹具和一个协作机械臂组成的机械系统用于抓取和牵引患肢。医生通过操纵杆控制台和Windows应用程序控制机器人。系统集成了一个双平面X线设备,这不仅便于医生随时查看骨折的X线图像,还便于他们在复位和康复前在图像上选择手腕的旋转轴。包括前后位和侧位X线数据以及复位和康复过程中的力与位置参数等重要信息显示在图形用户界面上。实验结果表明,所提出的机器人系统能够满足桡骨远端骨折复位和康复的技术要求,所有旋转角度均可实现,在所有牵引方向上均可实现超过50 N的最大力,并且使用X线图像选择腕关节旋转轴线的误差小于5 mm。所研发的机器人辅助系统被证明适用于桡骨远端骨折的闭合复位和康复,有望提高手术质量。