Development Of A Multifunctional Orthopaedic Robotic System And Validation For Its Application In Long Bone Fracture Reduction

Objective: Open reduction internal fixation(ORIF)surgery is a commonly used intervention for long bone fractures.The recovery after ORIF however is a long and painful process and the patients are also at a high risk of complications such as infection and movements or breakage of the installed hardware.In comparison,Chinese traditional orthopedics manual therapy has proven to fix bone fracture and alleviate pain effectively without an open surgery.However,this practice is empirical and highly dependent on the experience and skills of practitioners.Thus,there is no standard guidance on treatment procedures,rendering variable outcomes in the practice of Chinese Osteosyntheses.Due to the complexity in the processes of fracture reduction and recovery,methods depending solely on either open reduction or simple manual therapy do not meet the clinical demand for an effective treatment for bone fracture.To ensure a precise,consistent and fast relief fracture reduction and fixation without open surgeries,we therefore developed the state of the art multifunctional orthopaedic robotic system that combines the advantages of both traditional Chinese medical practice and contemporary treatment technologies in the field of orthopedics.Here we report that we have developed the first phase of multifunctional orthopaedic robot system named “Atlasus”,that is,construction of the concept prototype and validation for its application in long bone fracture reduction.Method: The prototype was developed based on a conceptual design of a four-arm orthopaedic robotic system with functional application in fracture reduction,joint replacement,spinal positioning and minimally invasive surgery.The low-dose C-arm fluoroscopy device performs image acquisition on the ortho and lateral positions of the femoral shaft model,and transmits the acquired images to a central computer for storage and measurement of fracture-related data.Its application on the fracture reduction system is evaluated by performing multiple reductions on the femoral shaft model.The results of the experiment were statistically analyzed.Results: The prototype of Multi-Functional Orthopedic Robotic system consists of a robot body(a low-dose C-arm navigation system,4 robotic arms with 6 degrees of freedom and equipped with bionic mechanical grippers including the mechanical hand metacarpophalangeal joint,the interphalangeal joint and the joint of thumb b),infrared emitting device,optical tracking device,operating table and control console.The parameters measured for the functional capacityof the long bone fracture reduction include a rotation angle of 1.5±0.43°,a lateral displacement of 0.82±0.02 mm,an angular displacement of 0.7±0.26°and an axial displacement of 0.25±0.02 mm.Conclusions: We have successfully developed a prototype of the world's first multi-functional orthopedic robot system,implemented with state-of-the-art mechanic engineering and imaging analysis enabling a delicate,consistent and precise maneuver of the mechanic arms for fracture reduction,joint replacement,spinal positioning and minimally invasive surgery.The prototype is simple to operate and has a wide range of applications.Based on the experimental results of the first stage,the accuracy of the reduction using the robotic system has exceeded current clinical requirement for fracture healing.This prototype has demonstrated the clinical significance and wide-range of application of the multifunctional orthopedic robotic system in orthopedic surgeries.