A 3-Legged Parallel Robot for Long Bone Fracture Alignment

Author(s):  
Mohammad H. Abedinnasab ◽  
Farzam Farahmand ◽  
Jaime Gallardo-Alvarado

The reduction of long bone fractures is traditionally an invasive procedure with drawbacks of intense force, soft tissue damage, and, both, rotational and longitudinal malalignment. To combat these drawbacks, we applied a novel, wide open, three-legged, 6-DOF parallel robot, to the current surgical procedure. This platform will balance the accuracy, payload, and workspace for the surgeon, resulting in more efficient, successful surgeries. The experimental tests on a phantom reveal that the mechanism is well capable of applying the desired reduction steps against the large muscular payloads with high accuracy.

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Mohammad H. Abedinnasab ◽  
Farzam Farahmand ◽  
Jaime Gallardo-Alvarado

Robotic reduction of long bones is associated with the need for considerable force and high precision. To balance the accuracy, payload, and workspace, we have designed a new six degrees-of-freedom three-legged wide-open robotic system for long-bone fracture reduction. Thanks to the low number of legs and their nonsymmetrical configuration, the mechanism enjoys a unique architecture with a frontally open half-plane. This facilitates positioning the leg inside the mechanism and provides a large workspace for surgical maneuvers, as shown and compared to the well-known Gough–Stewart platform. The experimental tests on a phantom reveal that the mechanism is well capable of applying the desired reduction steps against the large muscular payloads with high accuracy.


1993 ◽  
Vol 06 (01) ◽  
pp. 36-41 ◽  
Author(s):  
A. Steiner ◽  
U. Iselin ◽  
C. Lischer ◽  
J. A. Auer

This study demonstrates that long bone fracture treatment in food and fibre producing animals is in most cases successful. The greatest disadvantage of such treatment are the costs of the surgery and implants.


2015 ◽  
Vol 15 (01) ◽  
pp. 1550016 ◽  
Author(s):  
BINGYU WANG ◽  
JIKUANG YANG ◽  
OTTE DIETMAR ◽  
YONG PENG

This study aimed at prediction of long bone fractures and analysis of lower extremity injury mechanisms in real world passenger car to pedestrian collision. For this purpose, two cases of car to pedestrian accidents with detail recorded lower extremity injuries were reconstructed using Multi-body system (MBS) and Finite element (FE) models. The MBS models were used to determine lower extremity impact conditions, such as impact velocity, contact location as well as impact orientation. Furthermore, impact conditions were used to define initial boundary conditions in the simulation of lower extremity colliding with car front end using FE models. The bending moment and von Mises stress distributions of long bone were calculated in FE model to evaluate long bone fracture risks. Then, injury outcomes from simulations were compared with hospital recorded injury data. The simulation results of long bone fracture were consistent with the injury pattern and positions from hospital records. Moreover, the calculated fracture moments of tibia and fibula shaft as well as femur neck region were 310.8, 21.4 and 304.7 Nm, respectively. The FE model is capable to reproduce the dynamic injury process and is an effective tool to demonstrate the dynamic response of the injury and to predict the risk of long bone fractures.


2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Yanshi Liu ◽  
Hong Li ◽  
Jialin Liu ◽  
Xingpeng Zhang ◽  
Maimaiaili Yushan ◽  
...  

Abstract Background The hexapod external fixator (HEF), such as the Taylor spatial frame (TSF), offering the ability of multidirectional deformities correction without changing the structure, whereas there are so many parameters for surgeons to measure and subjective errors will occur inevitably. The purpose of this study was to evaluate the effectiveness of a new method based on computer-assisted three-dimensional (3D) reconstruction and hexapod external fixator for long bone fracture reduction and deformity correction without calculating the parameters needed by the traditional usage. Methods This retrospective study consists of 25 patients with high-energy tibial diaphyseal fractures treated by the HEF at our institution from January 2016 to June 2018, including 22 males and 3 females with a mean age of 42 years (range 14–63 years). Hexapod external fixator treatments were conducted to manage the multiplanar posttraumatic deformities with/without poor soft-tissue that were not suitable for internal fixation. Computer-assisted 3D reconstruction and trajectory planning of the reduction by Mimics were applied to perform virtual fracture reduction and deformity correction. The electronic prescription derived from the length changes of the six struts were calculated by SolidWorks. Fracture reduction was conducted by adjusting the lengths of the six struts according to the electronic prescription. Effectiveness was evaluated by the standard anteroposterior (AP) and lateral X-rays after reduction. Results All patients acquired excellent functional reduction and achieved bone union in our study. After correction, the mean translation (1.0 ± 1.1 mm) and angulation (0.8 ± 1.2°) on the coronal plane, mean translation (0.8 ± 1.0 mm) and angulation (0.3 ± 0.8°) on the sagittal plane were all less than those (6.1 ± 4.9 mm, 5.2 ± 3.2°, 4.2 ± 3.5 mm, 4.0 ± 2.5°) before correction (P < 0.05). Conclusions The computer-assisted three-dimensional reconstruction and hexapod external fixator-based method allows surgeons to conduct long bone fracture reduction and deformity correction without calculating the parameters needed by the traditional usage. This method is suggested to apply in those unusually complex cases with extensive soft tissue damage and where internal fixation is impossible or inadvisable.


2017 ◽  
Vol 4 (4) ◽  
Author(s):  
K. Harish Chandra Reddy ◽  
Puli Santosh Reddy ◽  
P. Kishan

Background: Depression is likely to affect the outcome of the patients with long bone fractures. It also affects the duration of stay post operatively and seeks more medical attention than in normal patients. Objective: To assess depression and its risk factors among patients with long bone fracture in Karimnagar district of Telangana Methods: Nature of the study was descriptive and design of the study is prospective and cross sectional in orthopedic Department of the teaching hospital. Population for the study was patient including inpatients and out patients of orthopedic department in follow up. Sample size 50 was selected for the further statistical analysis in the present study. Data was collected from patients and informants from orthopedic Department. Results: 60% patients had fractures in the lower limb. 53% patients had fractures of the right limb. 90% patients were with closed fractures. 89% patients underwent surgical management. Age, Type of Family, Type of Fracture and Type of Treatment were found to be significantly associated factors with Depression. (p < 0.05) Conclusion: Depression was common among patients undergoing orthopedic surgery for fracture of long bones. Depression was significantly associated with age, type of family, type of fracture and type of treatment.


2021 ◽  
Vol 3 (2) ◽  
pp. 40-47
Author(s):  
Arnold V. Popkov ◽  
Dmitriy A. Popkov ◽  
Konstantin V. Trofimov ◽  
Alexander I. Nikiforov ◽  
Alexey А. Isupov

The study concerns a new method of treatment of bone fractures of upper and lower limbs based on osteogenesis stimulation by intramedullary implants with bioactive organic hydroxyapatite (HA). The method decreases consolidation period of diaphyseal fractures to 2-4 times. A technology of osteosynthesis and bone formation dynamics at the fracture zone and around the implant is described.


2020 ◽  
Vol 25 (Supplement_2) ◽  
pp. e35-e35
Author(s):  
Nathalie Gaucher ◽  
Evelyne D Trottier ◽  
Zainab Ridha ◽  
Francois Simard ◽  
Brenda Duran ◽  
...  

Abstract Background Long bone fractures are a frequent reason for visits to the pediatric emergency department (ED) where patients obtain the definitive care they require. Youth are rarely involved in quality assessment and improvement initiatives. Objectives To describe parent and youth experiences of their ED care for suspected long bone fractures. Design/Methods This prospective survey study of parents/youth consulting a tertiary care pediatric ED used surveys co-constructed by ED clinicians and parent partners. English/French speaking patients aged 10 to 18 years old with suspected long-bone fracture at triage – and their parents – were eligible to complete the survey during their ED stay. Electronic surveys were developed for parents and youth and pre-tested with 12 youth and 14 parents. Descriptive data was generated using SPSS v.25 (IBM Inc.). Results Three hundred surveys were distributed to eligible participants from March 2018 to June 2019 and 249 surveys were completed (148 parents, 101 youth). At least one member from 189 families completed a survey. Parents and youth participants had median ages of 44 and 12 years old, respectively. Most patients (98%) had a radiograph as part of their work-up, usually in the ED (76%); Twenty-seven percent were referred with radiographs. Most families (61%) received a diagnosis of long-bone fracture and were referred to orthopaedics for outpatient follow-up. Families’ median length of stay was 4h08min (range 43 min-14h30min). Parents (88mm) and youth (81mm) reported high median satisfaction with their overall ED care on 100 mm visual analog scales. Most parents (81%) and youth (75%) reported receiving just enough information from ED staff, though only half (50%) of the parents received information on how to care for their child at home. More than 90% of parents believed that the ED team treated their child’s pain. Eighty-one percent of youth reported that pain was treated sufficiently although 63% believed it had been treated quickly. Most parents (56%) and youth (72%) reported their ED stay was longer than anticipated; parents’ perceptions did not correlate with ED length of stay on logistic regression (p=0.014), while youth’s did (p=0.009). Few parents (33%) or youth (32%) reported receiving regular information on ED wait times. Conclusion Parent and youth perspectives of their ED care are complementary, and both should be considered in patient-oriented quality improvement initiatives.


2020 ◽  
Vol 4 (2) ◽  
pp. 87-90
Author(s):  
Bayusentono Sulis ◽  
Cery Hajali

Long bones are bones that include the humerus, radius, ulna, femur, tibia and fibula. Aside from fibula, the main function of long bones is as the main skeleton in movement. Therefore, whenever there is a fracture in the long bone, the ability to move will be lost.The occurrence of this long bone fracture itself is still a global problem because the number of events is still quite large. This is in line with the increase in socioeconomic status and the incidence of traffic accidents which is one of the causes of fractures. METHOD This study is a prospective study to determine the magnitude of the cost of treatment conservatively in cases of long bone fractures in RSUD dr. Soetomo. The study design used was a prospective cohort. The sample size used in this study was determined by consecutive sampling, ie patients who met the inclusion criteria in the period May - August 2017. RESULTS From the observations for four months from May 2017 - August 2017 at Emergency Room Soetomo General Hospital, found 77 patients with long bone fractures that were casted. Of these patients, 38 patients were placed in a slab, 39 patients were placed in a circular cast. Among the 39 people, 17 patients were excluded according to the exclusion criteria and 22 patients were included as the study sample according to the inclusion criteria. By using a statistical test using paired sample T test with a value of α = 0.05, a significance of 0.025 was obtained. Because the significance value is 0.025 <0.05 (α). DISCUSSION From the resultsa difference between the BPJS rate of installing circular cast on long bone fractures with the real cost of installing circular cast on long bone fractures. In addition, from the value of the mean we get that the average value of the BPJS rate is greater than the real cost value, which means we can conclude that the BPJS cost can cover the cost of conservative therapy in cases of long bone fractures. CONCLUSION In the economic aspect, the longer the length of stay means the higher the costs that must be paid by the patient (the payer) and accepted by the hospital. This only applies to real tariffs, whereas to INACBG's long or short length of stay does not affect the cost.


Pain Medicine ◽  
2020 ◽  
Vol 21 (9) ◽  
pp. 1947-1954
Author(s):  
Amy L Drendel ◽  
David C Brousseau ◽  
T Charles Casper ◽  
Lalit Bajaj ◽  
Evaline A Alessandrini ◽  
...  

Abstract Objective To measure the variability in discharge opioid prescription practices for children discharged from the emergency department (ED) with a long-bone fracture. Design A retrospective cohort study of pediatric ED visits in 2015. Setting Four pediatric EDs. Subjects Children aged four to 18 years with a long-bone fracture discharged from the ED. Methods A multisite registry of electronic health record data (PECARN Registry) was analyzed to determine the proportion of children receiving an opioid prescription on ED discharge. Multivariable logistic regression was performed to determine characteristics associated with receipt of an opioid prescription. Results There were 5,916 visits with long-bone fractures; 79% involved the upper extremity, and 27% required reduction. Overall, 15% of children were prescribed an opioid at discharge, with variation between the four EDs: A = 8.2% (95% confidence interval [CI] = 6.9–9.7%), B = 12.1% (95% CI = 10.5–14.0%), C = 16.9% (95% CI = 15.2–18.8%), D = 23.8% (95% CI = 21.7–26.1%). Oxycodone was the most frequently prescribed opioid. In the regression analysis, in addition to variation by ED site of care, age 12–18 years, white non-Hispanic, private insurance status, reduced fracture, and severe pain documented during the ED visit were associated with increased opioid prescribing. Conclusions For children with a long-bone fracture, discharge opioid prescription varied widely by ED site of care. In addition, black patients, Hispanic patients, and patients with government insurance were less likely to be prescribed opioids. This variability in opioid prescribing was not accounted for by patient- or injury-related factors that are associated with increased pain. Therefore, opioid prescribing may be modifiable, but evidence to support improved outcomes with specific treatment regimens is lacking.


2021 ◽  
Vol 28 ◽  
pp. 39-46
Author(s):  
Ina Lackner ◽  
Birte Weber ◽  
Melanie Haffner-Luntzer ◽  
Simona Hristova ◽  
Florian Gebhard ◽  
...  

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