On the Use of a Continuum Manipulator and a Bendable Medical Screw for Minimally Invasive Interventions in Orthopedic Surgery.
On the Use of a Continuum Manipulator and a Bendable Medical Screw for Minimally Invasive Interventions in Orthopedic Surgery.
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DOI：
10.1109/tmrb.2019.2895780
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发表时间：
2019-03
期刊：
影响因子：
--
通讯作者：
Armand M
中科院分区：
文献类型：
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作者：
Alambeigi F;Bakhtiarinejad M;Sefati S;Hegeman R;Iordachita I;Khanuja H;Armand M
准确定位和稳定固定是传统医用螺钉骨折内固定的主要目标。这些目标对于加速和避免由于骨碎片未对准而导致的骨折愈合不当是必要的。然而，螺钉的刚性、骨折解剖结构（例如股骨和骨盆）的几何形状以及骨质疏松症可能会导致一系列并发症。为了应对这些挑战，我们建议使用连续机械手和可弯曲的医用螺钉（BMS）来钻弯曲的隧道并固定骨碎片。这种新颖的方法为临床医生提供了选择钻孔入口点以及在复杂解剖和骨质疏松骨骼中钻头导航的自由度。该技术还可以促进股骨头坏死的治疗和髋部增强以预防骨质疏松性骨折。在本文中：1）我们通过制作几个不同曲率的弯曲隧道来评估弯曲钻孔技术在人体标本上的性能，2）我们还通过对骨质疏松股骨骨折固定进行有限元模拟，证明了使用 BMS 与刚性直螺钉进行内固定的可行性。
Accurate placement and stable fixation are the main goals of internal fixation of bone fractures using the traditional medical screws. These goals are necessary to expedite and avoid improper fracture healing due to misalignment of the bone fragments. However, the rigidity of the screw, geometry of the fractured anatomy (e.g., femur and pelvis), and osteoporosis may cause an array of complications. To address these challenges, we propose the use of a continuum manipulator and a bendable medical screw (BMS) to drill curved tunnels and fixate the bone fragments. This novel approach provides the clinicians with a degree of freedom in selecting the drilling entry point as well as the navigation of drill in complex anatomical and osteoporotic bones. This technique can also facilitate the treatment of osteonecrosis and augmentation of the hip to prevent osteoporotic fractures. In this paper: 1) we evaluated the performance of the curved drilling technique on human cadaveric specimens by making several curved tunnels with different curvatures and 2) we also demonstrated the feasibility of internal fixation using the BMS versus a rigid straight screw by performing finite element simulation of fracture fixation in an osteoporotic femur.