title: Robot-assisted fracture reduction using three-dimensional intraoperative fracture visualization: an experimental study on human cadaver femora.
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 degrees vs. 8.4 degrees ) and for varus/valgus alignment (1.1 degrees vs. 2.5 degrees ). 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.
authors.affiliation: Department of Trauma Surgery, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany. m.oszwald@web.de
authors.forename: Markus
authors.initials: M
authors.lastname: Oszwald
authors.forename: Ralf
authors.initials: R
authors.lastname: Westphal
authors.forename: Jan
authors.initials: J
authors.lastname: Bredow
authors.forename: Afshin
authors.initials: A
authors.lastname: Calafi
authors.forename: Tobias
authors.initials: T
authors.lastname: Hufner
authors.forename: Friedrich
authors.initials: F
authors.lastname: Wahl
authors.forename: Christian
authors.initials: C
authors.lastname: Krettek
authors.forename: Thomas
authors.initials: T
authors.lastname: Gosling
mesh_terms: D002102:Cadaver; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D005471:Fluoroscopy; D005592:Fracture Fixation / Q000295:instrumentation* / Q000379:methods* / Q000592:standards; D006801:Humans; D021621:Imaging, Three-Dimensional; D008838:Microcomputers; D016343:Monitoring, Intraoperative / Q000379:methods; D015203:Reproducibility of Results; D012371:Robotics / Q000295:instrumentation* / Q000379:methods* / Q000592:standards