A Novel Computer-Assisted System for Long Bone Fracture Reduction With a Hexapod External Fixator

Objective: Accurate alignment of long bone fractures under minimally invasive procedures is a prerequisite for excellent treatment outcomes. However, the existing technologies suffer from the drawbacks of complex operations and excessive dependence on the surgeon's expertise. To solve these problems, we have developed a novel computer-assisted system to achieve rapid and effective reduction of fractures. Methods: The automatic registration of the bone-fixator is accomplished based on the principal component analysis and the markers recognition. Then, the fracture reduction target is acquired by utilizing the Iterative Closest Point algorithm on the mirrored contralateral bone model. Next, the optimal reduction trajectory is automatically generated by considering collision detection, muscle pull force analysis, and trajectory optimization. Finally, the strut adjustment plan of the fixator is provided to the surgeon, combined with the results of bone-fixator registration. Result: Modeling experiments verified the high accuracy of the system registration and the superiority of the reduction planning method, and clinical trials demonstrated the effectiveness and feasibility of the proposed system for fracture treatment. Conclusion: The proposed system facilitates accurate and efficient planning of fracture reduction for surgeons through simple manipulation. Significance: Our system enables a one-stop automatic acquisition of prescriptions for external fixation treatment of fractures.