CN117064556A - Clamping method applied to robot-assisted femoral fracture reduction treatment operation - Google Patents
Clamping method applied to robot-assisted femoral fracture reduction treatment operation Download PDFInfo
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- CN117064556A CN117064556A CN202311045859.XA CN202311045859A CN117064556A CN 117064556 A CN117064556 A CN 117064556A CN 202311045859 A CN202311045859 A CN 202311045859A CN 117064556 A CN117064556 A CN 117064556A
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- Prior art keywords
- clamping
- fracture reduction
- robot
- affected limb
- femur
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- 238000000034 method Methods 0.000 title claims abstract description 18
- 208000008924 Femoral Fractures Diseases 0.000 title claims abstract description 11
- 210000000988 bone and bone Anatomy 0.000 claims abstract description 33
- 208000010392 Bone Fractures Diseases 0.000 claims abstract description 32
- 210000003414 extremity Anatomy 0.000 claims abstract description 32
- 210000000689 upper leg Anatomy 0.000 claims abstract description 26
- 210000003205 muscle Anatomy 0.000 claims description 6
- 238000001356 surgical procedure Methods 0.000 claims description 4
- 210000002414 leg Anatomy 0.000 claims description 3
- 239000007787 solid Substances 0.000 claims 1
- 230000000642 iatrogenic effect Effects 0.000 abstract description 5
- 238000002513 implantation Methods 0.000 abstract description 2
- 208000000860 Compassion Fatigue Diseases 0.000 abstract 1
- 206010017076 Fracture Diseases 0.000 description 15
- 206010052428 Wound Diseases 0.000 description 3
- 208000027418 Wounds and injury Diseases 0.000 description 3
- 210000004872 soft tissue Anatomy 0.000 description 3
- 208000006670 Multiple fractures Diseases 0.000 description 2
- 230000001054 cortical effect Effects 0.000 description 2
- 238000002474 experimental method Methods 0.000 description 2
- 208000003044 Closed Fractures Diseases 0.000 description 1
- 230000009286 beneficial effect Effects 0.000 description 1
- 238000010586 diagram Methods 0.000 description 1
- 238000003780 insertion Methods 0.000 description 1
- 230000037431 insertion Effects 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 238000011160 research Methods 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/30—Surgical robots
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/60—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like for external osteosynthesis, e.g. distractors, contractors
- A61B17/62—Ring frames, i.e. devices extending around the bones to be positioned
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/72—Intramedullary pins, nails or other devices
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
- A61B17/90—Guides therefor
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/30—Surgical robots
- A61B2034/304—Surgical robots including a freely orientable platform, e.g. so called 'Stewart platforms'
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- Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Engineering & Computer Science (AREA)
- Medical Informatics (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Robotics (AREA)
- Neurology (AREA)
- Surgical Instruments (AREA)
Abstract
The invention belongs to the field of medical equipment, and provides a clamping method applied to a robot-assisted femoral fracture reduction treatment operation, which comprises the following specific steps: s1: placing the patient on a surgical traction table, and fixing the proximal end of the affected limb on the surgical traction table according to a conventional surgical scheme; s2: the fracture reduction device is moved to the rear of the operation traction table, and the driving gear motor is driven to prop up the clamping plates of the annular femur fixing mechanism, so that the affected limb can pass through the clamping plates; according to the invention, the distal ends of the affected limbs are fixed by combining the rigid cancellous bone screw and the flexible clamping piece, the positioning function can be realized by a single screw, the secondary trauma to a patient is reduced, the cancellous bone screw does not bear the task of carrying and clamping, the problem of stress concentration in the traditional screw clamping and carrying is effectively avoided, thereby avoiding the risk of iatrogenic bone fracture, and meanwhile, the position of the cancellous bone screw is positioned on cancellous bone, so that the subsequent intramedullary nail implantation is not blocked, and the subsequent operation is convenient.
Description
Technical Field
The invention belongs to the field of medical equipment, and particularly relates to a clamping method applied to a robot-assisted femoral fracture reduction treatment operation.
Background
In the current active fracture reduction robot system research, the method for performing the reduction operation is to directly drive a single cortical nail or a double cortical nail into the far-end cortex of the broken bone model, and then clamp the screw to move by a mechanical arm or a step platform provided with a screw connecting piece, so that the movement of the robot is transmitted to the far end of the broken bone model, and the reduction of the far end and the near end of the broken bone model is realized;
however, in actual long bone fracture treatment surgery, an intramedullary nail is required to be placed in the intramedullary cavity for fixing the reduction state after the fracture reduction step is achieved; the screw penetrates through the medullary cavity along the vertical direction of the medullary cavity axis by using the double-cortical screw to fix the distal end of the fractured bone for the reduction operation, so that the subsequent intramedullary nail implantation operation cannot be performed, and a great iatrogenic wound is caused to a patient; the use of a single-skin screw to fix the distal end can ensure the follow-up intramedullary nail placement operation, but because the diameter of the screw which is allowed to be placed is limited by the closed fracture reduction operation, the contact area between the screw and the cortex is small, the depth of the screw placed into the cortex is shallow, the mass of muscle tissue is large, the traction force required for moving the soft tissue is large, the problem of stress concentration easily exists in the cortex of the screw, and the potential iatrogenic fracture and the risk of screw slipping are provided; in summary, the current method for resetting the affected limb of the patient by using the screw has limitation, can only be applied to a broken bone model resetting experiment for removing soft tissues, and cannot be applied to clinic.
Disclosure of Invention
In order to solve the technical problems, the invention provides a clamping method applied to a robot-assisted femoral fracture reduction treatment operation, which aims to solve the problems that the method for reducing the affected limb of a patient by using a screw in the prior art has limitations, can only be applied to a reduction experiment of a broken bone model for removing soft tissues, cannot be applied to clinic and the like.
A clamping method applied to a robot-assisted femoral fracture reduction treatment operation comprises the following specific steps:
s1: placing the patient on a surgical traction table, and fixing the proximal end of the affected limb on the surgical traction table according to a conventional surgical scheme;
s2: the fracture reduction device is moved to the rear of the operation traction table, and the driving gear motor is driven to prop up the clamping plates of the annular femur fixing mechanism, so that the affected limb can pass through the clamping plates;
s3: pushing the fracture reduction device forwards to enable the affected limb to pass through the annular femur fixing mechanism, stopping after reaching a proper position of the far end of the affected limb, placing the affected limb shank on the hydraulic lifting bracket, adjusting the height of the hydraulic lifting bracket to lift the affected limb shank, and then fixing the device;
s4: driving the driving gear motor to reversely rotate, so that the clamping sheet is tightened to clamp the distal end of the affected limb, and adjusting the height of the lower leg to a proper position by using the hydraulic lifting bracket to perform coarse positioning operation;
s5: installing a cancellous bone fixing ring, and placing cancellous bone screws into the distal cancellous bone of the femur of the patient along the access device to perform fine positioning operation;
s6: starting a Stewart platform to execute fracture reduction operation;
s7: the reduction posture is fixed by the fracture reduction device, and the intramedullary nail is placed along the intramedullary nail access point.
Preferably, in the step S2, three groups of flexible clamping pieces are arranged in the annular femur fixing mechanism, so that the clamping force can be applied to the muscle tissue of the leg in three directions simultaneously by surface contact, and the force application is uniform.
Preferably, in the step S3, the hydraulic lifting bracket may be replaced by a common lifting table, and the annular femur clamping mechanism may be replaced by a conventional clamp.
Preferably, the fracture reduction device adopted in the step S2 comprises a reduction robot, a Stewart platform arranged on the reduction robot, a universal wheel is arranged at the bottom of the reduction robot, an annular femur fixing mechanism is arranged at the top of the Stewart platform, a cancellous bone fixing ring is arranged at one side of the annular femur fixing mechanism, and a hydraulic lifting bracket is arranged at the top of the reduction robot at one side of the Stewart platform.
Compared with the prior art, the invention has the following beneficial effects:
1. according to the invention, the distal ends of the affected limbs are fixed by combining the rigid spongy bone screws and the flexible clamping pieces, the rigid spongy bone screws are combined with the Stewart platform, so that the relative positions of the distal ends of the broken bones and the Stewart platform are unchanged, the positioning function can be realized by a single screw, the secondary wounds to a patient are reduced, meanwhile, the flexible clamping pieces are used for transmitting main clamping force, the clamping force can be applied to muscle tissues of the affected limbs in three directions simultaneously in a contact-free manner, and the comfort level of the patient is improved while the force application is uniform.
2. According to the invention, the spongy bone screw is not used for carrying and clamping, so that the problem of concentrated carrying stress of the traditional screw clamping is effectively avoided, the risk of iatrogenic bone fracture is avoided, and meanwhile, the spongy bone screw is positioned on the spongy bone, so that the insertion of a subsequent intramedullary nail is not blocked, and the subsequent operation in the resetting operation process is facilitated.
Drawings
FIG. 1 is a schematic view of a fracture reduction device of the present invention;
FIG. 2 is a schematic view of a cancellous bone fixation ring according to the present invention;
FIG. 3 is a schematic view of the intramedullary nail entry point location of the present invention;
fig. 4 is a block diagram of the specific steps of the present invention.
In the figure:
1. resetting the robot; 2. a universal wheel; 3. a Stewart platform; 4. an annular femur fixing mechanism; 5. a hydraulic lifting bracket; 6. a cancellous bone fixation ring; A. intramedullary nail access points.
Detailed Description
Embodiments of the present invention are described in further detail below with reference to the accompanying drawings and examples. The following examples are illustrative of the invention but are not intended to limit the scope of the invention.
As shown in fig. 1 to 4:
embodiment one: the invention provides a clamping method applied to a robot-assisted femoral fracture reduction treatment operation, which comprises the following specific steps:
s1: placing the patient on a surgical traction table, and fixing the proximal end of the affected limb on the surgical traction table according to a conventional surgical scheme;
s2: the fracture reduction device is moved to the rear of the operation traction table, and the driving gear motor is driven to prop up the clamping plates of the annular femur fixing mechanism, so that the affected limb can pass through the clamping plates;
s3: pushing the fracture reduction device forwards to enable the affected limb to pass through the annular femur fixing mechanism, stopping after reaching a proper position of the far end of the affected limb, placing the affected limb shank on the hydraulic lifting bracket, adjusting the height of the hydraulic lifting bracket to lift the affected limb shank, and then fixing the device;
s4: driving the driving gear motor to reversely rotate, so that the clamping sheet is tightened to clamp the distal end of the affected limb, and adjusting the height of the lower leg to a proper position by using the hydraulic lifting bracket to perform coarse positioning operation;
s5: installing a cancellous bone fixing ring, and placing cancellous bone screws into the distal cancellous bone of the femur of the patient along the access device to perform fine positioning operation;
s6: starting a Stewart platform to execute fracture reduction operation;
s7: the reduction pose is fixed by the fracture reduction device and the intramedullary nail is placed along the intramedullary nail access point, which is shown at a in fig. 3.
Specifically, in the step S2, three groups of flexible clamping pieces are arranged in the annular femur fixing mechanism, so that the clamping force can be applied to the muscle tissues of the legs in three directions simultaneously by surface contact, and the force application is uniform.
Specifically, in the step S3, the hydraulic lifting bracket can be replaced by a common lifting table, the annular femur clamping mechanism can be replaced by a traditional clamp, the production and use cost is reduced, and the annular femur clamping mechanism is convenient for personnel to use.
Specifically, the fracture reduction device that adopts in step S2 includes, reduction robot 1, sets up the Stewart platform 3 on reduction robot 1, and universal wheel 2 is installed to the bottom of reduction robot 1, and annular femur fixing mechanism 4 is installed at the top of Stewart platform 3, and spongy bone fixing ring 6 is installed to one side of annular femur fixing mechanism 4, and hydraulic lifting bracket 5 is installed at the reduction robot 1 top of Stewart platform 3 one side.
From the above, the distal ends of the affected limbs are fixed by combining the rigid spongy bone screws and the flexible clamping sheets, the rigid spongy bone screws are combined with the Stewart platform 3, the relative positions of the distal ends of broken bones and the Stewart platform 3 are unchanged, the positioning function can be realized by a single screw, secondary wounds to patients are reduced, meanwhile, the flexible clamping sheets are used for transmitting main clamping force, clamping force can be applied to muscle tissues of the affected limbs in three directions at the same time in a contact-free manner, the comfort level of the patients is improved, meanwhile, the spongy bone screws do not bear the tasks of carrying and clamping, the problem of stress concentration of clamping and carrying of the traditional screws is effectively avoided, so that the risk of iatrogenic bone fracture is avoided, meanwhile, the position of the spongy bone screws is located on the spongy bone, the subsequent intramedullary nail is not blocked, and the subsequent operation in the resetting operation process is facilitated.
Working principle: the method comprises the steps of placing a patient on an operation traction table, fixing the proximal end of an affected limb on the operation traction table according to a conventional operation scheme, moving a fracture reduction device to the rear of the operation traction table through universal wheels 2, driving a driving gear motor to open clamping plates of an annular femur fixing mechanism 4, enabling the affected limb to push forwards through the clamping plates, enabling the affected limb to pass through the annular femur fixing mechanism 4, stopping the affected limb after reaching a proper position of the distal end of the affected limb, placing the lower leg of the affected limb on a hydraulic lifting bracket 5, adjusting the height of the hydraulic lifting bracket 5 to lift the lower leg of the affected limb, then driving a driving gear motor to reversely rotate through fixing universal wheels 2 to enable the clamping plates to clamp the distal end of the affected limb, adjusting the height of the lower leg to a proper position through the hydraulic lifting bracket 5 to perform rough positioning operation, installing a spongy bone fixing 6, placing spongy bone screws into spongy mass of the distal end of a patient along an access device to perform fine positioning operation, starting a Stewart platform 3 to perform resetting operation, fixing the reset posture through the resetting device, and placing the spongy bone screws into the intramedullary nail along the access points of the bone.
While embodiments of the present invention have been shown and described above for purposes of illustration and description, it will be understood that the above embodiments are illustrative and not to be construed as limiting the invention, and that variations, modifications, alternatives, and variations may be made to the above embodiments by one of ordinary skill in the art within the scope of the invention.
Claims (4)
1. The clamping method applied to the robot-assisted femoral fracture reduction treatment operation is characterized by comprising the following steps of: the method comprises the following specific steps:
s1: placing the patient on a surgical traction table, and fixing the proximal end of the affected limb on the surgical traction table according to a conventional surgical scheme;
s2: the fracture reduction device is moved to the rear of the operation traction table, and the driving gear motor is driven to prop up the clamping plates of the annular femur fixing mechanism, so that the affected limb can pass through the clamping plates;
s3: pushing the fracture reduction device forwards to enable the affected limb to pass through the annular femur fixing mechanism, stopping after reaching a proper position of the far end of the affected limb, placing the affected limb shank on the hydraulic lifting bracket, adjusting the height of the hydraulic lifting bracket to lift the affected limb shank, and then fixing the device;
s4: driving the driving gear motor to reversely rotate, so that the clamping sheet is tightened to clamp the distal end of the affected limb, and adjusting the height of the lower leg to a proper position by using the hydraulic lifting bracket to perform coarse positioning operation;
s5: installing a cancellous bone fixing ring, and placing cancellous bone screws into the distal cancellous bone of the femur of the patient along the access device to perform fine positioning operation;
s6: starting a Stewart platform to execute fracture reduction operation;
s7: the reduction posture is fixed by the fracture reduction device, and the intramedullary nail is placed along the intramedullary nail access point.
2. A clamping method applied to a robot-assisted femoral fracture reduction treatment surgery according to claim 1, wherein: in the step S2, three groups of flexible clamping pieces are arranged in the annular femur fixing mechanism, so that clamping force can be applied to muscle tissues of the legs in three directions simultaneously in a surface contact mode, and the force application is uniform.
3. A clamping method applied to a robot-assisted femoral fracture reduction treatment surgery according to claim 1, wherein: in the step S3, the hydraulic lifting bracket may be replaced by a common lifting table, and the annular femur clamping mechanism may be replaced by a conventional clamp.
4. A clamping method applied to a robot-assisted femoral fracture reduction treatment surgery according to claim 1, wherein: the fracture reduction device that adopts in step S2 includes, reset robot (1), set up in reset robot (1) is last Stewart platform (3), universal wheel (2) are installed to the bottom of reset robot (1), annular femur fixed establishment (4) are installed at the top of Stewart platform (3), spongy bone solid fixed ring (6) are installed to one side of annular femur fixed establishment (4), hydraulic lifting bracket (5) are installed at reset robot (1) top of Stewart platform (3) one side.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202311045859.XA CN117064556A (en) | 2023-08-18 | 2023-08-18 | Clamping method applied to robot-assisted femoral fracture reduction treatment operation |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202311045859.XA CN117064556A (en) | 2023-08-18 | 2023-08-18 | Clamping method applied to robot-assisted femoral fracture reduction treatment operation |
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| Publication Number | Publication Date |
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| CN117064556A true CN117064556A (en) | 2023-11-17 |
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| Application Number | Title | Priority Date | Filing Date |
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| CN202311045859.XA Pending CN117064556A (en) | 2023-08-18 | 2023-08-18 | Clamping method applied to robot-assisted femoral fracture reduction treatment operation |
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Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN118000882A (en) * | 2024-04-03 | 2024-05-10 | 吉林大学 | Frame-type fracture reduction surgical robot |
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2023
- 2023-08-18 CN CN202311045859.XA patent/CN117064556A/en active Pending
Cited By (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN118000882A (en) * | 2024-04-03 | 2024-05-10 | 吉林大学 | Frame-type fracture reduction surgical robot |
| CN118000882B (en) * | 2024-04-03 | 2024-06-04 | 吉林大学 | Frame-type fracture reduction surgical robot |
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