Quantification of manipulation forces needed for robot-assisted reduction of the ankle syndesmosis: an initial cadaveric study.
Quantification of manipulation forces needed for robot-assisted reduction of the ankle syndesmosis: an initial cadaveric study.
复制标题
对机器人辅助减少踝关节疾病所需的操纵力的量化：最初的尸体研究。
DOI：
10.1007/s11548-022-02705-0
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发表时间：
2022-12
影响因子：
3
通讯作者：
Li, Gang
中科院分区：
文献类型：
--
作者：
Gebremeskel, Mikias;Shafiq, Babar;Uneri, Ali;Sheth, Niral;Simmerer, Corey;Zbijewski, Wojciech;Siewerdsen, Jeffrey H.;Cleary, Kevin;Li, Gang
关键词：
在涉及远端胫腓联合扭伤的踝关节骨折中，手动手术操作胫骨和腓骨是必要的，以正确对齐和减少间隙。然而，手动复位是高度可变的，在大约一半的情况下可能导致复位不良。因此，我们正在开发一种图像引导机器人助手来提高还原精度。本研究的目的是量化与踝关节联合复位相关的力，以确定我们机器人设计的要求。使用尸体标本，我们设计了一种固定夹具将胫骨安全地固定在手术台上。我们还设计了一个定制的腓骨抓板，其上附有一个力-扭矩测量装置。外科医生使用该结构手动复位腓骨，同时测量平移和旋转力以及位移。在韧带联合韧带被切断后，首次在没有韧带损伤的完整踝关节上进行手术。在尸体踝关节的三个主要复位方向上进行了六种手法。结果表明：侧向施加的最大力为96.0 N，最大位移为8.5 mm；前后向施加的最大力为71.6 N，最大位移为10.7 mm；内外旋转施加的最大扭矩为2.5 Nm，最大旋转为24.6°。执行远端胫腓联合操作所需的具体力尚不清楚。本研究量化了精确复位踝关节联合所需的操纵力及其位移。这是帮助我们从力和位移方面定义机器人辅助设计要求的必要的第一步。
Manual surgical manipulation of the tibia and fibula is necessary to properly align and reduce the space in ankle fractures involving sprain of the distal tibiofibular syndesmosis. However, manual reduction is highly variable and can result in malreduction in about half of the cases. Therefore, we are developing an image-guided robotic assistant to improve reduction accuracy. The purpose of this study is to quantify the forces associated with reduction of the ankle syndesmosis to define the requirements for our robot design. Using a cadaveric specimen, we designed a fixture jig to fix the tibia securely on the operating table. We also designed a custom fibula grasping plate to which a force–torque measuring device is attached. The surgeon manually reduced the fibula utilizing this construct while translational and rotational forces along with displacement were being measured. This was first performed on an intact ankle without ligament injury and after the syndesmosis ligaments were cut. Six manipulation techniques were performed on the three principal directions of reduction at the cadaveric ankle. The results demonstrated the maximum force applied to the lateral direction to be 96.0 N with maximum displacement of 8.5 mm, applied to the anterior–posterior direction to be 71.6 N with maximum displacement of 10.7 mm, and the maximum torque applied to external–internal rotation to be 2.5 Nm with maximum rotation of 24.6°. The specific forces needed to perform the distal tibiofibular syndesmosis manipulation are not well understood. This study quantified these manipulation forces needed along with their displacement for accurate reduction of ankle syndesmosis. This is a necessary first step to help us define the design requirements of our robotic assistance from the aspects of forces and displacements.
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影响因子：
2.7
作者：
Lloyd, John;Elsayed, Sherief;Tanaka, Hiro
通讯作者：
Tanaka, Hiro
影响因子：
2.3
作者：
Sagi, H. Claude;Shah, Anjan R.;Sanders, Roy W.
通讯作者：
Sanders, Roy W.
影响因子：
3.3
作者：
Herzog, Mackenzie M.;Kerr, Zachary Y.;Wikstrom, Erik A.
通讯作者：
Wikstrom, Erik A.
影响因子：
1
作者：
Mehta SS;Rees K;Cutler L;Mangwani J
通讯作者：
Mangwani J
DOI：
10.2106/00004623-199712000-00006
发表时间：
1997-12-01
影响因子：
5.3
作者：
Thordarson, DB;Motamed, S;Bakshian, S
通讯作者：
Bakshian, S