A robot-assisted system for long bone intramedullary distal locking: Concept and preliminary results

This paper presents a new robot-based system to assist orthopaedic surgeons in performing distal intramedullary locking in femoral and tibial fracture reduction. The system consists of a miniature bone-mounted robot fitted with a drill guide that provides mechanical guidance for manual drilling of the distal screws' pilot holes. The drill guide and the nail's distal locking holes axes are automatically aligned with a few X-ray fluoroscopic images. The goal is to eliminate the guesswork from drill positioning, thus reducing surgery time and surgeon's cumulative radiation exposure, and to ensure drill and hole's axis alignment during drilling, thus eliminating geometric errors and their complications. We describe the system's rationale and concept, its architecture and usage protocol, the image processing and registration algorithms, and preliminary experimental results.