Robotic reduction of complex fractures using 3D puzzle solving algorithm

身体的关节经常发生骨折，通常被归类为关节内骨折。如果关节要再次正常工作，也就是提供无痛的稳定和运动，关节的断片必须进行解剖复位，例如尽可能完美地重新组合在一起。该项目的目的是为创造一种机器人设备奠定研究基础，该设备使用最先进的3D成像、模式识别和机器人技术对复杂的关节骨折进行精确的解剖复位。医院的创伤成本是巨大的，机器人技术可能带来的节省是有希望的。我们相信，布里斯托尔机器人实验室充满活力的跨学科环境及其与布里斯托尔皇家医院的密切合作使调查人员处于绝佳的地位，可以利用他们的机器人和临床专业知识与Simpleware开发的商业3D成像软件解决方案相结合的机会。创伤在医疗支出中所占比例最高。过去30年，BRI肢体单元一直处于损伤研究的前沿。在机器人方面，BRL一直是一个快速发展的机器人实验室，在许多服务和集群机器人领域拥有广泛的专业知识。为了促进矫形机器人领域的研究，我们在布里斯托尔大学整形外科系(罗杰·阿特金斯教授)、布里斯托尔机器人实验室(S·多格拉马齐博士)、英格兰西部大学精细印刷研究中心(P·沃尔特斯博士和D·侯森博士)和一家软件公司(Simpleware Ltd.)之间建立了合作关系。这项提议是第一次尝试开始实现一个雄心勃勃的想法，该想法可能会给广大利益攸关方带来好处。这是一项可行性研究，旨在开发一种新型的机器人设备，能够在适当的自主性水平上减少复杂的关节骨折。在这个阶段，需要开发一种自动的3D拼图求解算法，以允许计算断裂关节节段的整体对齐中的最佳路径。当骨折在模拟中成功复位后，下一步是开发一种机器人设备，使用横跨关节的细丝圆形框架来操作骨折关节的部件。这将使患者和工作人员更少地接触CT扫描，相当大的资源节省，更快的恢复和更少的肢体疤痕。机器人辅助手术是一个新兴的跨学科领域，旨在改善外科手术的结果，减少术中时间和对患者和工作人员的辐射暴露，并将各种手术程序的侵入性降至最低。医疗机器人和计算机辅助手术似乎很有可能成为未来社会的一个普遍元素；有许多迹象表明，医疗机器人和计算机辅助手术将是改善生活和商业开发的巨大机遇。2006年，全球MRCAS设备和设备的市场总额约为13亿美元，预计到2011年将达到57亿美元，年均增长率为34.7%。在这个项目中有一个天然的协同作用；PI在机器人方面有良好的记录，在数学和控制方面有很强的背景，顾问是一位经验丰富的临床医生，拥有矫形外科发展的学术组合。合作公司Simpleware将在项目期间提供他们的软件许可证以及软件支持。BRL的快速成型设施将有助于实现该项目的硬件，并将从BRI的医疗档案中获得的真实骨折可视化。

The joints of the body are frequently involved in bone breaks, typically classified as intra-articular fractures. If a joint is to function properly again, that is to provide pain-free stability and movement, the broken pieces of the joint must be subjected to an anatomic reduction e.g. put back together as perfectly as possible. This project's aim is to set a research basis for creating a robotics device for precise anatomic reduction of complex, joints' fractures using the state of the art of 3D imaging, pattern recognition and robotics. The cost of trauma in hospitals is massive and a saving that robotics could potentially bring is promising. We believe that Bristol Robotics Laboratory's vibrant cross-disciplinary environment and its close association with Bristol Royal Infirmary places the investigators in an excellent position to exploit the opportunity of combining their robotics and clinical expertise with commercial 3D imaging software solutions developed by Simpleware.Trauma accounts for the highest proportion of healthcare expenditure. The BRI Limb unit has been at the forefront of injury research for the past three decades. BRL has, on the robotics side, been a fast developing robotics laboratory with a wide expertise in many areas of service and swarm robots. In order to promote the research in the area of orthopaedic robotics, we have formed a collaboration between the department of orthopedic surgery at the University of Bristol (Professor Roger Atkins), the Bristol Robotics Laboratory (Dr S Dogramadzi), the Centre for Fine Print Research at the University of the West of England (Dr P Walters and Dr D Huson) and a software company (Simpleware Ltd). This proposal is a first attempt to initiate the realization of an ambitious idea that can potentially bring benefits to a broad community of stakeholders. It is a feasibility study that aims to develop a novel robotic device capable of reducing complex joint fractures at the appropriate level of autonomy. An automated 3D jigsaw solving algorithm needs to be developed at this stage that would allow calculation of the optimum paths in overall alignment of the broken joint's segments. When the fracture is successfully reduced in simulation, the next step is to develop a robotic device to manipulate the fractured joint's parts using a fine wire circular frame applied across the joint. This will allow less exposure to CT scan for patients and staff, considerable resource saving, more rapid recovery and less scarring of the limb.Robot assisted surgery is an emerging interdisciplinary field that aims at improving the outcome of surgical procedures, reducing intra-operative time and radiation exposure to patients and staff as well as minimizing the invasiveness of a variety of surgical procedures. It seems very likely that Medical Robotics and Computer Assisted Surgery (MRCAS) will be a pervasive element of future society; there are many indications e.g. MRCAS report (http://www.piribo.com/publications/medical_devices/medical_robotics_computerassisted_surgery.html) that this will be a huge opportunity for life enhancement and commercial exploitation. The total worldwide market for MRCAS devices and equipment was around $1.3 billion in 2006 and is expected to reach $5.7 billion by 2011, an average annual grow rate of 34.7%. There is a natural synergy in this project; the PI has a track record in robotics and a strong background in mathematics and control, the Advisor is an experienced clinician with an academic portfolio of developments in orthopaedics surgery. The collaborating company Simpleware will provide their software licence for the duration of the project as well as the software support. BRL's rapid prototyping facilities will contribute to realisation of the project's hardware and the visualisation of the real fractures obtained from BRI's medical archives.