[Corrections using the hexapod]

Medical Robotics in Bone Fracture Reduction Surgery: A Review

Since the advantages of precise operation and effective reduction of radiation, robots have become one of the best choices for solving the defects of traditional fracture reduction surgery. This paper focuses on the application of robots in fracture reduction surgery, design of the mechanism, navigation technology, robotic control, interaction technology, and the bone-robot connection technology. Through literature review, the problems in current fracture reduction robot and its future development are discussed.

[The Taylor Spatial Frame. Correction of posttraumatic deformities of the tibia and hindfoot]

INTRODUCTION

Posttraumatic deformities in the lower limb are mainly multidirectional, with angulation, translation, and rotatory deformities. Acute corrections with internal fixation are often not possible due to the soft tissue damage and the extent of the deformity. The Taylor Spatial Frame (TSF) allows correction in a virtual hinge with 6 axes, thus enabling the correction of multidirectional deformities simultaneously.

METHODS

From February 2003 until December 2006, we applied 31 TSFs to 20 patients with a posttraumatic deformity of the tibia and hindfoot. The mean patient age was 41 years (range 12-73). 9 patients had a nonunion of the tibia with deformity, 6 had a malunion of the lower tibia and ankle, 3 had an angular deformity after ankle fusion, and 2 had malaligned Ilizarov bone segment transports. The mean follow-up time was 25.3 months (range 10-82).

RESULTS

In all 20 patients, full correction of the deformity was achieved. The mean time for correction was 29 days (range 5-82). On average, the frame was worn (time to healing) 164.2 days (80-300) and the mean distraction rate was 1.1 mm/day (0.5-2.0). The Web-based planning was done two times per case for full deformity correction. Complications were 3 pin-site infections, 2 insufficient callus formations and 1 pinhole stress fracture.

CONCLUSIONS

The main advantage of the TSF compared with other external frames is the ability to perform simultaneous correction of angular, axial, translational, and rotatory deformities. This enables a reduced correction time and increased patient comfort.