PFI-TT: Surgical Robotic System for Long Bone Fracture Alignment

这项创新-技术转化伙伴关系（PFI-TT）项目的更广泛影响/商业潜力是大大减少股骨（大腿骨）骨折手术的错位和相关并发症。超过一半的骨折发生在长骨，比如股骨。在美国，每年发生43万例股骨骨折；在全球范围内，机动车事故每年造成约1-3百万例股骨干骨折。由于骨骼的细长解剖结构和周围肌肉的相反力量，手动对齐长骨的手术是艰巨而困难的，需要外科医生和医务人员在手术过程中施加很高的牵引力。骨碎片排列不良是潜在的严重并发症，三分之一的患者需要额外的矫正手术，这增加了费用和并发症。该机器人通过消除重复操作和减少手术时间来降低医疗成本。通过改善患者的治疗效果和降低护理成本，这对患者、外科医生和医院都有好处。该项目旨在开发一种用于长骨骨折手术的骨科手术机器人系统。28%的患者发生15°或更多的旋转不良。不对齐导致腿长差异和步态异常。提出的概念包括一个手术机器人、抓骨系统和控制机器人的力反馈控制器。这使外科医生能够准确地施加较大的牵引力并精确地对齐骨折。所提出的结构包括一个带有两个大开口环的三臂机械手；它便于在机器人内部定位腿部，为手术操作提供了一个大的工作空间。目标是：(1)优化设计以提供高度精确的骨段对齐；(2)开发力反馈控制器以精确对齐骨段，并结合软件预测肌肉力。为了实现这些目标，研究将采用机械设计优化、分析建模、计算、实验和尸体测试。结果将是一个机器人平台，可以进一步整合图像引导路径规划算法，用于长骨骨折的解剖对齐。该奖项反映了美国国家科学基金会的法定使命，并通过使用基金会的知识价值和更广泛的影响审查标准进行评估，被认为值得支持。

The broader impact/commercial potential of this Partnerships for Innovation - Technology Translation (PFI-TT) project is to greatly reduce malalignments and associated complications from femoral (thigh bone) fracture surgery. More than half of all fractures occur in long bones like the femur. In the United States, 430,000 femur fractures occur annually; and globally, motor vehicle accidents cause an estimated 1-3 million femoral shaft fractures each year. Surgery to manually align long bones is arduous and difficult due to the bone’s elongated anatomy and the opposing strength of the surrounding muscles, requiring the surgeon and medical staff to exert high traction forces during the procedure. Poor alignment of the bone fragments is a potentially serious complication, and one-third of patients experiencing this require additional corrective surgery that increases costs and more complications. The proposed robot reduces healthcare costs by eliminating repeated operations and decreasing procedure times. This benefits patients, surgeons, and hospitals by improving patient outcomes and reduces the cost of care. The proposed project develops an orthopedic surgical robotic system for long-bone fracture surgeries. A malrotation of 15° or more occurs in 28% of patients. Malalignment leads to leg-length discrepancies and abnormal gait. The proposed concept consists of a surgical robot, bone-gripping system, and force-feedback controller to manipulate the robot. This enables the surgeon to accurately apply large traction forces and precisely align the fractured bone. The proposed architecture consists of a 3-armed manipulator with two wide-open rings; it facilitates positioning the leg inside the robot, providing a large workspace for surgical maneuvers. The objectives are to: (1) optimize the design to provide highly accurate alignment of bone segments and (2) develop a force-feedback controller to accurately align bone segments, coupled with software to predict muscle forces. To achieve these objectives, the research will employ mechanical design optimization, analytical modeling, computation, experimentation, and testing on cadavers. The outcome will be a robotic platform that can be further integrated with image-guided path-planning algorithms for anatomic alignment of long-bone fractures.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.