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- Bewegungsanalyse <Technik> (1)
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Reduction of femoral shaft fractures in vitro by a new developed reduction robot system "RepoRobo"
(2004)
Closed reduction of the long bones is associated with the use of
considerable force. This force must be maintained for the reduction maneuver and fixation process. At present, apart from the extension table or the large AO distractor, only rather inadequate reduction aids are available. A solution to this problem is being sought in the form of a robotic system with which precision can be improved and the holding effort reduced. In the research project presented here, a synthetic femur with integrated tensioned mainspring and a 32-A3 type
fracture served as a bone reduction model. The fracture was stabilized with a standard AO fixator. A Stäubli robot (model RX130) was converted by appropriate modification so that it could be used for the reduction of femoral shaft fractures in vitro. The robot was equipped with a pneumatic 2-fingered gripper, on which the fingers have
been modified so that they can grip the AO fixator clamp. A Force-Feedback-Sensor was inserted between the gripper and the robot to obtain online recordings of the forces and moments in all three axes. With this setup it is possible to achieve precise reduction of the fracture in all planes under visual control.
The application of robotics in manufacturing industry is increasingly spreading to other fields such as service, security and medical, and more recently into orthopedic surgery. Most research projects to date have concentrated on the lighter side of non‐invasive surgery, camera, laser guidance, light cutting and milling through bone. Just as in industrial production and processing applications, the choice of robot and its accompanying control and programming system is absolutely paramount. This simple fact has been justified in recent research dealing with the heavier forms of fracture repositioning robotics in accident surgery. This paper discusses the development of the complete system including robot, end‐effector and sensors.
The mechanical complications of osteosyntheses after hip fractures are previously investigated by mostly static or dynamic uniaxial loading test systems. However, the physiologic loading of the hip joint during a normal gait is a multiplanar, dynamic movement. Therefore, we constructed a system to test osteosyntheses for hip fractures under physiologic multiplanar loading representative of normal gait. To evaluate the testing system, 12 femora pairs were tested under 25,000 cycles with two standard osteosyntheses (Proximal Femoral Nail Antirotation/Gamma3 Nail). For angular movement, the varus collapse to cut out (∝CO) (∝CO=4.8°±2.1° for blade and ∝CO=7.8°±3.8° for screw) was the dominant failure mode, and only slight rotational angle shifts (∝Rot) (∝Rot=1.7°±0.4° for blade and ∝Rot=2.4°±0.3° for screw) of the femoral head around the implant axis were observed. Angular displacements in varus direction and rotation were higher in specimens reinforced with screws. Hence, the cut out model and the migration directions showed a distinction between helical blade and hip screw. However, there were no significant differences between the different implants. The new setup is able to create clinical failures and allows to give evidence about the anchorage stability of different implant types under dynamic gait motion pattern.