Robotic distal locking of intramedullary nailing: Technical description and cadaveric testing.

Journal: The international journal of medical robotics + computer assisted surgery : MRCAS
PMID: 28544676

Abstract

Interlocked intramedullary nailing is the treatment of choice for femoral shaft fractures. However, distal locking is a technically challenging part of the procedure that can result in distal femoral malrotation and high radiation exposure. We have tested a robotic procedure for robotic distal locking based on the computation of a drilling trajectory on two calibrated fluoroscopic images. Twenty distal holes were attempted in ten cadaveric femur specimens. Successful screw hole drilling was achieved at the first attempt in each of the ten specimens (20 drill holes in total). No failures were recorded. The average total number of images needed was 6.5 +/- 3.6. The average computation time was 16.5+/- 16.0 seconds. Robotic distal locking was feasible in this test and can be integrated into a fully robotic intramedullary nailing procedure.

Authors

  • Martin Panzica
    Trauma Department, Hannover Medical School, Hannover, Germany.
  • Eduardo M Suero
    Trauma Department, Hannover Medical School, Hannover, Germany.
  • Ralf Westphal
    Institute for Robotics and Process Control, Braunschweig University of Technology, Germany.
  • Musa Citak
    Trauma Department, Hannover Medical School, Hannover, Germany.
  • Emmanouil Liodakis
    Trauma Department, Hannover Medical School, Hannover, Germany.
  • Nael Hawi
    Trauma Department, Hannover Medical School, Hannover, Germany.
  • Max Petri
    Trauma Department, Hannover Medical School, Hannover, Germany.
  • Christian Krettek
    Trauma Department, Hannover Medical School, Hannover, Germany.
  • Timo Stuebig
    Trauma Department, Hannover Medical School, Hannover, Germany.

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