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Robot‐assisted fracture reduction using three‐dimensional intraoperative fracture visualization: An experimental study on human cadaver femora
Authors:Markus Oszwald  Ralf Westphal  Jan Bredow  Afshin Calafi  Tobias Hufner  Friedrich Wahl  Christian Krettek  Thomas Gosling
Affiliation:1. Department of Trauma Surgery, Hannover Medical School, Carl‐Neuberg‐Strasse 1, 30625 Hannover, Germany;2. Institute for Robotics and Process Control, Technical University of Braunschweig, Muehlenpfordstrasse 23, 38106 Braunschweig, Germany;3. Department of Orthopaedic Surgery, Harborview Medical Center, University of Washington, 325 9th Avenue, Seattle, Washington 98104
Abstract:Closed fracture reduction can be a challenging task. Robot‐assisted reduction of the femur is a newly developed technique that could minimize potential complications and pitfalls associated with fracture reduction and fixation. We conducted an experimental study using 11 human cadaver femora with intact soft tissues. We compared robot‐assisted fracture reduction using 3D visualization with manual reduction, using 2D fluoroscopy. The main outcome measure was the accuracy of reduction. The manual reductions were done by an experienced orthopedic trauma surgeon, whereas the robot‐assisted reductions were done by surgeons of different experience. The robot‐assisted group showed significantly less postreduction malalignment (p < 0.05) for internal/external rotation (2.9° vs. 8.4°) and for varus/valgus alignment (1.1° vs. 2.5°). However, the reduction time was significantly (p < 0.01) longer (6:14 min vs. 2:16 min). The higher precision associated with robot‐assisted fracture reduction makes this technique attractive and further research and development worthwhile. In particular, less experienced surgeons may benefit from this new technique. © 2010 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 28:1240–1244, 2010
Keywords:robot‐assisted surgery  three‐dimensional visualization  robotic fracture reduction  analysis of precision  femur fracture
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