CN106361441B - Master-slave type femoral shaft fracture reduction parallel robot system and method - Google Patents
Master-slave type femoral shaft fracture reduction parallel robot system and method Download PDFInfo
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- CN106361441B CN106361441B CN201610832181.3A CN201610832181A CN106361441B CN 106361441 B CN106361441 B CN 106361441B CN 201610832181 A CN201610832181 A CN 201610832181A CN 106361441 B CN106361441 B CN 106361441B
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- 230000009467 reduction Effects 0.000 title claims abstract description 67
- 238000000034 method Methods 0.000 title abstract description 10
- 238000013507 mapping Methods 0.000 claims abstract description 37
- 210000000689 upper leg Anatomy 0.000 claims abstract description 35
- 230000000399 orthopedic effect Effects 0.000 claims abstract description 28
- 230000003068 static effect Effects 0.000 claims description 43
- 230000000875 corresponding effect Effects 0.000 claims description 15
- 210000000988 bone and bone Anatomy 0.000 claims description 13
- 238000004904 shortening Methods 0.000 claims description 12
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- 230000006378 damage Effects 0.000 abstract description 5
- 208000014674 injury Diseases 0.000 abstract description 5
- 238000002360 preparation method Methods 0.000 abstract description 5
- 206010017076 Fracture Diseases 0.000 description 61
- 208000010392 Bone Fractures Diseases 0.000 description 60
- 229910000831 Steel Inorganic materials 0.000 description 9
- 239000010959 steel Substances 0.000 description 9
- 230000009286 beneficial effect Effects 0.000 description 6
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- 230000009977 dual effect Effects 0.000 description 5
- 238000001356 surgical procedure Methods 0.000 description 3
- 206010052428 Wound Diseases 0.000 description 2
- 238000010586 diagram Methods 0.000 description 2
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- 230000000694 effects Effects 0.000 description 2
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- 208000006670 Multiple fractures Diseases 0.000 description 1
- 208000002565 Open Fractures Diseases 0.000 description 1
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- 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
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- 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
- A61B17/64—Devices extending alongside the bones to be positioned
- A61B17/6408—Devices not permitting mobility, e.g. fixed to bed, with or without means for traction or reduction
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- A—HUMAN NECESSITIES
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- 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
- A61B17/64—Devices extending alongside the bones to be positioned
- A61B17/645—Devices extending alongside the bones to be positioned comprising a framework
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- A—HUMAN NECESSITIES
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- A61G—TRANSPORT, PERSONAL CONVEYANCES, OR ACCOMMODATION SPECIALLY ADAPTED FOR PATIENTS OR DISABLED PERSONS; OPERATING TABLES OR CHAIRS; CHAIRS FOR DENTISTRY; FUNERAL DEVICES
- A61G13/00—Operating tables; Auxiliary appliances therefor
- A61G13/10—Parts, details or accessories
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- 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
- A61B2017/564—Methods for bone or joint treatment
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- 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
- A61B2017/606—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 with resilient spring element
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61G—TRANSPORT, PERSONAL CONVEYANCES, OR ACCOMMODATION SPECIALLY ADAPTED FOR PATIENTS OR DISABLED PERSONS; OPERATING TABLES OR CHAIRS; CHAIRS FOR DENTISTRY; FUNERAL DEVICES
- A61G2210/00—Devices for specific treatment or diagnosis
- A61G2210/10—Devices for specific treatment or diagnosis for orthopedics
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Abstract
The invention provides a master-slave type femoral shaft fracture reduction parallel robot system and a method, wherein the system comprises a master hand control robot, a central controller, a slave hand reduction robot, a mapping switch, an orthopedic operating table, a traction frame, a G-type arm double-display X-ray machine and an operation trolley; the central controller transmits the conditional mapping of the fracture reduction operation of the master hand control robot to the slave hand reduction robot; the mapping switch turns on or off the conditional mapping operation of the central controller; the proximal femur of the patient is fixed on the orthopedic operating table; the traction frame is connected with the orthopedic operating table to form a rigid body; the slave hand resetting robot copies the fracture resetting operation of the master hand control robot on the patient under the mapping control of the central controller; the G-type arm double-display X-ray machine simultaneously collects an orthotopic X-ray image and a lateral X-ray image of a fracture position of a femoral shaft of a patient. The method includes pre-operative preparation and intra-operative manipulation steps. The invention reduces the X-ray injury to the operator and stably maintains the reset state before fixation.
Description
Technical Field
The invention belongs to the field of orthopaedics robots, and particularly relates to a master-slave type femoral shaft fracture reduction parallel robot system and method.
Background
Femoral shaft fractures are a clinically common disease in orthopedics. When a medical staff performs the reduction treatment on the patients, the fracture proximal end is required to be fixed, the fracture distal end is stretched through observing an X image, and then the fracture distal end is aligned with the proximal fracture for reduction, and then the fracture proximal end is fixed. Because of the developed muscles around the femur, reduction often requires two to three doctors to complete together. And it is difficult to fix the same while maintaining the reset state. The femoral shaft fracture reduction operation treatment based on intramedullary nail internal fixation is also a reduction method widely used clinically. The treatment means has the advantages that the radiation dose of rays is large, so that the radioactive exposure time of an operator is long during treatment, and the reduction effect on axial rotation fracture is poor. The operation belongs to open operation, and the incision wound surface is larger. The open fracture reduction has large blood loss, the wound of the patient is easy to be infected, and the wound healing time is long.
Disclosure of Invention
In order to solve the problem of long radioactive exposure time of an operator during treatment in the prior art, one aspect of the invention provides a master-slave femoral shaft fracture reduction parallel robot system, which comprises: the system comprises a master hand control robot, a central controller, a slave hand reset robot, a mapping switch, an orthopedic operating table, a traction frame, a G-type arm double-display X-ray machine and an operation trolley; the main hand control robot is a manual push-pull rod six-degree-of-freedom parallel mechanism robot and is used for receiving and executing fracture reduction operation instructions of operators; the central controller is connected with the master hand-operated robot and the slave hand-reset robot and is used for conditionally mapping and transmitting fracture reset operation of the master hand-operated robot to the slave hand-reset robot; the mapping switch is connected with the central controller and is used for switching on or switching off conditional mapping operation of the central controller; the proximal femur end of a patient is fixed on the orthopedic operating table, and the patient is a patient with fracture of the femoral shaft and is in a knee bending posture; the traction frame and the orthopedic operating table are connected into a rigid body; the slave hand resetting robot is an electric push-pull rod six-degree-of-freedom parallel mechanism robot, a distal end fixing platform of the slave hand resetting robot is fixed on the traction frame, and a proximal end moving platform of the slave hand resetting robot is used for fixing the distal femur end of a patient through bone nails or bone needles and copying fracture resetting operation of the master hand operation robot on the patient under the mapping control of the central controller; the G-type arm double-display X-ray machine is used for simultaneously collecting an orthotopic X-ray image and a lateral X-ray image of a fracture position of a femoral shaft of a patient; the main hand control robot and the central controller are fixed on the operation trolley; wherein the fracture reduction operation instruction is made by an operator according to the observed positive position X-ray image and the lateral position X-ray image.
In the system as described above, preferably, the slave hand resetting robot includes: the device comprises a far-end fixed platform, a near-end movable platform, six electric push-pull rods and six pairs of universal joints; the far-end fixing platform is disc-shaped; the near-end moving platform is in a two-thirds circular shape; six electric push-pull rods are connected between the far-end fixed platform and the near-end movable platform through six pairs of universal joints and used for executing corresponding actions under the mapping control of the central controller; the universal joints are used for connecting two end parts of an electric push-pull rod with the corresponding far-end fixed platform and the corresponding near-end movable platform respectively.
In the system as described above, preferably, the central controller is further configured to directly control the stroke of the electric push-pull rod; the system further comprises: a recovery key, an extension key and a shortening key which are respectively connected with the central controller; the recovery key is used for recovering the electric push-pull rod from the current stroke to half of the rated stroke; the extension key is used for gradually extending the electric push-pull rod from the current stroke; the shortening key is used for gradually shortening the electric push-pull rod from the current stroke.
In the system as described above, preferably, the master hand-manipulated robot includes: the mobile phone comprises a main mobile phone robot static platform, a main mobile phone robot dynamic platform, six manual distance sensing push-pull rods and six pairs of universal joints; the main mobile phone robot static platform is disc-shaped and is fixed on the operation trolley; the main mobile phone robot dynamic platform is disc-shaped and is used for receiving fracture reduction operation instructions of the operator; six manual distance sensing push-pull rods are positioned between the main mobile phone robot static platform and the main mobile phone robot dynamic platform; the universal joints are used for connecting two end parts of one manual distance sensing push-pull rod with the corresponding main mobile phone robot static platform and the corresponding main mobile phone robot dynamic platform respectively.
In the system as described above, preferably, the master hand-manipulated robot further includes: a tension spring; the extension spring is connected between the main mobile phone robot static platform and the main mobile phone robot dynamic platform and is positioned on the outer side of the circumference of the main mobile phone robot static platform and the circumference of the main mobile phone robot dynamic platform.
In the system as described above, preferably, the universal joint is a flexible universal joint.
In the system as described above, preferably, the map switch is a foot switch, and the foot switch is disposed on the ground.
In the system as described above, preferably, the system further comprises: and the lead screen is arranged between the G-type arm double-display X-ray machine and the operator.
The invention also provides a method for carrying out master-slave femoral shaft fracture reduction by adopting the system, which comprises the following steps: a pre-operative preparation step and an intra-operative manipulation step; the preoperative preparation steps specifically comprise: fixing the master hand control robot and the central controller on the operation trolley, and fixing a remote fixing platform of the slave hand resetting robot on the traction frame; the central controller is connected with the master hand control robot, the slave hand reset robot and the mapping switch; connecting the traction frame and the orthopedic operating table into a rigid body; enabling a patient with fracture of the femoral shaft to lie on the orthopedic operation table, fixing the proximal end of the femur of the patient on the orthopedic operation table, and enabling the tibia of the patient to drop to be in a knee bending shape; adjusting the position of the traction frame, aligning the proximal moving platform of the slave hand resetting robot to the distal femur of the patient, and fixing the distal femur on the proximal moving platform of the slave hand resetting robot through a steel needle and a bone nail; the position of a G-type arm of the G-type arm double-display X-ray machine is moved, and two emitting receivers of the G-type arm are respectively aligned with the right position and the side position of the fracture of the femoral shaft; the operation steps in the operation specifically comprise: turning on a power switch of the central controller and a power switch of the G-type arm double-display X-ray machine; and observing a double display screen of the G-arm double-display X-ray machine, controlling a dynamic platform of a host robot of the master hand control robot, and realizing teleoperation of the slave hand reduction robot to perform femoral shaft fracture reduction operation.
In the above method, preferably, the proximal moving platform is in a two-thirds ring shape, the proximal moving platform is first sleeved on the distal femur of the patient with knee bending, and then the distal femur is fixed on the proximal moving platform of the slave hand reposition robot through a steel needle and a bone nail.
The technical scheme provided by the embodiment of the invention has the beneficial effects that:
By establishing a mapping of the master hand manipulator robot and the slave hand reset robot, the X-ray injury to medical staff is avoided or reduced.
The proximal moving platform of the robot reset by hand can maintain the posture unchanged under the static condition and has the same holding force as the reset operation, so that the manpower required by medical staff before fixing the fracture in order to keep the reset state after the fracture is reset is released.
By utilizing the characteristic that the orthopedic operation table and the traction frame are one rigid body, the distal end fixing platform of the slave hand reduction robot is fixed on the traction frame, so that the proximal femur end fixed on the orthopedic operation table and the fixing platform fixed on the traction frame are regarded as one rigid body, and when the proximal end moving platform of the slave hand reduction robot performs fracture reduction motion, the distal femur end fixed on the proximal femur end moving platform is driven to move simultaneously to realize fracture reduction, thereby being beneficial to the femoral reduction of patients.
Drawings
Fig. 1 is a schematic structural view of a slave hand-resetting robot, a patient, a traction frame, an orthopedic operating table and a G-shaped arm according to an embodiment of the present invention.
Fig. 2 is a schematic structural view of a slave hand-resetting robot, a patient and a traction frame according to an embodiment of the present invention.
Fig. 3 is a schematic structural diagram of a master hand-operated robot according to an embodiment of the present invention.
Fig. 4 is a schematic structural view of a flexible universal joint according to an embodiment of the present invention.
Fig. 5 is a positional relationship diagram of a lead screen, an operation area and an operation area according to an embodiment of the present invention.
The symbols in the drawings illustrate:
1-master hand control robot, 11-master mobile robot static platform, 12-master mobile robot dynamic platform, 13-distance sensing push-pull rod, 14-flexible universal joint, 15-extension spring, 16-ring control handle, 17-static platform extension, 18-dynamic platform extension, 2-central controller, 3-slave hand reset robot, 31-distal fixed platform, 32-proximal mobile platform, 33-electric push-pull rod, 34-flexible universal joint, 4-orthopedic operation table, 5-traction frame, 6-G type arm double-display X-ray machine, 61-G type arm, 62-double display screen, 7-patient, 70-semicircular connector, 71-femur distal end, 72-femur proximal end, 24-foot switch, 21-recovery key, 22-extension key, 23-shortening key, 9-lead screen, 91-operating area, 92-operating area, 10-operating table car.
Detailed Description
For the purpose of making the objects, technical solutions and advantages of the present invention more apparent, the embodiments of the present invention will be described in further detail with reference to the accompanying drawings.
The use of the Li Zhanuo f (ILIZAROV) external fixator provides a new approach to fracture reduction. The steel needle and the steel nail penetrate through the skin and are fixed with bone segments at two sides of the broken end, and the end parts of the steel needle and the steel nail are respectively connected with two circular rings of the external fixator. Because the two rings are respectively connected with the bone segments at the two sides of the broken end to form two integers, the relative movement of the two rings can drive the relative movement of the two broken bones, thereby realizing fracture reduction. The Stuttgart (STEWART) parallel robot is based on the fracture reduction principle of an external Islamic fixator, and two rings are connected with six electric push-pull rods through six pairs of hinges, so that six degrees of freedom of relative displacement and rotation are realized, and the functions of fracture alignment and fracture reduction are realized. The following master hand-manipulated robot 1 and slave hand-reset robot 3 of the present invention are realized on the basis of the structure of a stuttt parallel robot.
Referring to fig. 1 to 5, an embodiment of the present invention provides a master-slave femoral shaft fracture parallel robot system, which includes: the robot comprises a master hand-operated robot 1, a central controller 2, a slave hand-reset robot 3, a mapping switch, an orthopedic operating table 4, a traction frame 5, a G-type arm double-display X-ray machine 6 and an operation trolley 10.
The main hand-operated robot 1 is a manual push-pull rod six-degree-of-freedom parallel mechanism robot, namely, the push-pull rod of the main hand-operated robot is a manual push-pull rod, the driving force of the main hand-operated robot is manpower, and the main hand-operated robot is used for executing fracture reduction operation instructions of an operator (namely, an operator), wherein the fracture reduction operation instructions are made by the operator according to the observed positive X-ray image and the lateral X-ray image acquired by the G-arm double-display X-ray machine 6 and are transmitted to the main hand-operated robot 1 through hands. The central controller 2 is connected with the master hand-operated robot 1 and the slave hand-reset robot 3, respectively, and is used for transmitting the conditional mapping of the fracture resetting operation of the master hand-operated robot 1 to the slave hand-reset robot 3. The map switch 24 is connected to the central controller 2 for turning on or off the conditional map control of the central controller 2. For example, when the map switch 24 is pressed, the central controller 2 maps the fracture reduction operation of the master hand-manipulated robot 1 to the slave hand-reduced robot 3; the map switch 24 is released, and the central controller 2 does not transmit the operation map of the master hand-manipulated robot 1 to the slave hand-reset robot 3, thereby achieving the on or off of the condition map. The slave hand reset robot 3 is an electric push-pull rod six-degree-of-freedom parallel mechanism robot, namely the push-pull rod of the slave hand reset robot 3 is an electric push-pull rod, the driving force of the slave hand reset robot is from a motor, and the slave hand reset robot is used for carrying out fracture reset operation on a patient along with the master hand control robot 1 under the mapping control of the central controller 2. The proximal femur 72 of the patient with the fracture of the femoral shaft is fixed to the orthopaedic surgical bed 4 prior to surgery (i.e., prior to reduction surgery), for example, by using bone nails or bone pins through a semicircular connector 70 or using bandages. Proximal femur refers to: the femur is near one end of the patient's torso, and the distal femur refers to: the femur is distal to the patient's torso. To facilitate repositioning, the patient lies on the orthopaedic operating table 4 in a bent knee position. The traction frame 5 is connected with the orthopedic operation table 4 into a rigid body, a far-end fixing platform of the slave hand resetting robot 3 is fixed on the traction frame 5, a femur far end of a patient is fixed on a near-end moving platform of the slave hand resetting robot 3, the traction frame 5 is used for adjusting the position of the slave hand resetting robot 3 to enable the near-end moving platform to be aligned with the patient, and the near-end moving platform (or called a motion resetting end) refers to: one end of a patient is fixed on the hand reduction robot 3, and the hand reduction robot moves during operation, so that the fracture bone segment of the distal femur of the patient fixed by the hand reduction robot is driven to move, and reduction is realized; the distal fixed platform (or fixed stationary end) refers to: one end of the manual reset robot 3 fixed on the traction frame 5 is not fixed on a patient, and the manual reset robot is static due to the fixation of the traction frame 5 during operation. The G-arm dual-display X-ray machine 6 is used for simultaneously acquiring an orthotopic X-ray image and a lateral X-ray image of a fracture of a femoral shaft of a patient, and comprises: a G-shaped arm 61, a dual display 62, and a console connected to the G-shaped arm 61 and the dual display 62, respectively. The two pairs of emitters of the G-arm 61 are aligned with the alignment and lateral positions of the fracture of the femoral shaft respectively to realize simultaneous sampling of the alignment and lateral images. The console is used to convey the positive and lateral images sampled by the G-arm 61 to the dual display 62. The dual display 62 is used to simultaneously display the normal X-ray image and the lateral X-ray image of the femoral shaft fracture. The master manipulator robot 1 and the central controller 2 are fixed to the operation carriage 10.
The invention uses the characteristic that the orthopedic operation table 4 and the traction frame 5 are connected into a rigid body (namely, the orthopedic operation table 4 and the traction frame 5 are the same rigid body), and the distal end fixing platform 31 of the slave hand-reset robot 3 is fixed on the traction frame 5, so that the proximal femur 72 of the patient fixed on the orthopedic operation table 4 and the distal end fixing platform 31 fixed on the traction frame 5 are regarded as a rigid body. The operator observes patient normal position X-ray image and side position X-ray image that G type arm dual-display X-ray machine obtained during the operation, then control the owner's hand with the hand and control robot 1 and carry out the fracture reduction operation, then under the effect of central controller 2, conditional mapping control is from hand reduction robot 3, make from the near-end mobile platform 32 of hand reduction robot 3 duplicate the fracture reduction operation of owner's hand control robot 1, and then drive the distal end 71 of femur that fixes on near-end mobile platform 32 and move, realize the reduction of femoral shaft fracture, accomplish the teleoperation to the reduction of femoral shaft fracture patient, so make the operator keep away from the operation area (or G type arm dual-display X-ray machine), can avoid or reduce the X-ray injury that the operator or medical personnel received.
It should be noted that: when the six electric push-pull rods are connected with the far-end fixed platform 31 and the near-end movable platform 32, one ends of the six electric push-pull rods 33 are divided into three groups, each group comprises one ends of two electric push-pull rods 33, and the interval between every two adjacent groups is 120 degrees; the other ends of the six electric push-pull rods 33 are also divided into three groups, each group containing the other ends of two electric push-pull rods 33, with 120 ° spacing between adjacent groups. And one end of each electric push-pull rod 33 is 60 deg. different from the other end in a plane perpendicular to the plane directed from the distal fixed platform 31 to the proximal moving platform. One group of the electric push-pull rods on the 2/3 ring should be positioned above, and the other two groups are positioned at 120 degrees on two sides. When the six manual distance sensing push-pull rods are connected with the main mobile robot static platform 11 and the main mobile robot dynamic platform, the connection positions are the same as those of the six electric push-pull rods, and the details are not repeated here.
The slave hand resetting robot 3 includes: a distal fixed platform 31, a proximal mobile platform 32, six motorized push-pull rods 33 and a universal joint. The distal fixation platform 31 is preferably disc-shaped so as to facilitate fixation to the traction frame 5 to remain stationary during surgery under fixation of the traction frame 5. The proximal moving platform 32 is in a two-thirds ring shape (or 2/3 ring shape), in other words, a notch is formed on the ring, the circumference of the notch is one third of the circumference of the ring (or 1/3 ring notch), the proximal moving platform 31 is sleeved on the distal femur 71 by using the 1/3 ring notch, the distal femur 71 is fixed by a steel needle and a bone nail on the 2/3 ring, and the distal femur 71 of the patient with knee bending is sleeved and fixed on the 2/3 ring by using the 1/3 ring notch before operation to facilitate the resetting operation. Six electric push-pull rods 33 are connected between the distal fixed platform 31 and the proximal movable platform 32 for driving the movement of the proximal movable platform 32. A pair of universal joints 34 are used to connect two ends of one electric push-pull rod 33 with the corresponding distal fixed platform 31 and proximal movable platform 32, respectively, specifically, one end of the electric push-pull rod 33 is connected with the proximal movable platform 32 through one universal joint, and the other end of the electric push-pull rod 33 is connected with the distal fixed platform 31 through another universal joint, which are collectively referred to as a pair of universal joints.
To facilitate accurate and stable fracture reduction of the patient, the central controller 2 is also adapted to directly control the stroke of the electric push-pull rod 33, the system further comprising: a recovery key 21, an extension key 22 and a shortening key 23, which are connected to the central controller 2, respectively. The recovery key 21 is used for simultaneously controlling the six electric push-pull rods 33 to recover from the current stroke to half of the rated stroke, for example, the rated stroke is 50mm, half of the rated stroke is 25mm, and when the recovery key 21 is pressed, the six electric push-pull rods 33 are all recovered from the current stroke to 25mm. The extension key 22 is used for simultaneously controlling the six electric push-pull rods 33 to gradually extend from the current stroke, and when the extension key 22 is pressed, the current stroke of the six electric push-pull rods 33 is kept slowly extended until the extension key 22 is released. The shortening key 23 is used for simultaneously controlling the six electric push-pull rods 33 to be gradually shortened from the current stroke, and when the shortening key 23 is pressed, the current stroke of the six electric push-pull rods 33 is kept slowly shortened until the shortening key 23 is released.
The master hand control robot 1 comprises a master hand robot static platform 11, a master mobile phone robot dynamic platform 12, six distance sensing push-pull rods 13 and universal joints. The main mobile phone robot static platform 11 is preferably disc-shaped, so that the main mobile phone robot static platform is conveniently fixed on the operation trolley 10, and the operation trolley 10 is preferably positioned beside an operation platform of the G-arm double-display X-ray machine so as to be convenient for fracture reduction operation. The main mobile robot dynamic platform 12 is disc-shaped, preferably disc-shaped with a hollowed hole, and is used for receiving fracture reduction operation instructions of a surgeon, and a circular ring control handle 16 is connected to the outer side of the main mobile robot dynamic platform 12 in the circumferential direction so as to be beneficial to the operation of the surgeon. Six manual distance sensing push-pull rods 13 are connected between the main mobile robot static platform 11 and the main mobile robot dynamic platform 12 and are used for generating corresponding six-degree-of-freedom displacement and rotation under fracture reduction operation of an operator. The pair of universal joints 14 are used for connecting two ends of one manual distance sensing push-pull rod 13 with the corresponding main mobile robot static platform 11 and main mobile robot dynamic platform 12 respectively, specifically, one end of the manual distance sensing push-pull rod 13 is connected with the main mobile robot dynamic platform 12 through one universal joint 14, the other end of the manual distance sensing push-pull rod 13 is connected with the main mobile robot static platform 11 through another universal joint, and the one universal joint and the another universal joint are collectively called as a pair of universal joints.
The universal joint of the master hand-manipulated robot 1 and the universal joint of the slave hand-reset robot 3 are preferably flexible universal joints 14, 34, each comprising: the universal joint spring and the screw rod which is respectively connected with the two ends of the universal joint spring in a threaded manner are arranged on the outer side of the universal joint spring. The flexible universal joint is in threaded connection with the electric push-pull rod 33 or the manual distance sensing push-pull rod 13 or the main mobile robot dynamic platform 12 or the main mobile robot static platform 11 or the slave hand reset robot far-end fixed platform 31 or the slave hand reset robot near-end moving platform 32 through the other end of the screw rod. The flexible universal joint is perpendicular to the plane where the host robot dynamic platform 12 or the host robot static platform 11 or the remote fixed platform 31 or the near-end moving platform 32 is located, corresponding to the axis of the section where the host robot dynamic platform 12 or the host robot static platform 11 or the remote fixed platform 31 or the near-end moving platform 32 is connected. The other section of the flexible universal joint connected with the manual distance sensing push-pull rod 13 or the electric push-pull rod 13 coincides with the axis of the manual distance sensing push-pull rod 13 or the electric push-pull rod 33. In other embodiments, a rigid gimbal is also possible.
In order to allow the master hand-manipulated robot 1 to return to the initial state (i.e., each sensor push-pull rod is minimized) when not interacting with the operator (without any external force), the master hand-manipulated robot 1 further includes: and an extension spring 15 connected between the main mobile robot static platform 11 and the main mobile robot dynamic platform 12, and located at the circumferential outer sides of the main mobile robot static platform 11 and the main mobile robot dynamic platform 12. For example, along the radial direction of the main mobile robot static platform 11, a static platform extension 17 is extended and installed at the edge of the main mobile robot static platform 11, a dynamic platform extension 18 is installed at the edge of the main mobile robot dynamic platform 12 corresponding to the static platform extension 17 along the radial direction of the main mobile robot dynamic platform 12, and an extension spring 15 is vertically connected between the static platform extension 17 and the dynamic platform extension 18. Specifically, the static platform extension 17 is connected (e.g., bolted) to the outer side of the static platform 11 of the master mobile robot, that is, in the axial direction perpendicular to the static platform 11 of the master mobile robot, the plane formed by the static platform 11 of the master mobile robot and the plane formed by the static platform extension 17 are not coplanar. The bottom surface of the dynamic platform extension 18 is connected (e.g. bolted) to the outer side surface of the main mobile robot dynamic platform 12, the circular control handle 16 is connected to the top surface of the dynamic platform extension 18, i.e. in the axial direction perpendicular to the main mobile robot dynamic platform 12, the plane formed by the circular control handle 16, the plane formed by the main mobile robot dynamic platform 12 and the plane formed by the dynamic platform extension 18 are not coplanar, i.e. in the direction from the main mobile robot dynamic platform 12 to the main mobile robot static platform 11, the circular control handle 16, the dynamic platform extension 18 and the main robot dynamic platform 12 are sequentially. When the tension spring 15 is installed, a through hole can be formed in the static platform extension 17, correspondingly, a through hole is formed in the dynamic platform extension 18, and the tension spring 15 is hooked between the through holes through hooks at two ends of the tension spring, so that the tension spring is arranged between the static platform extension 17 and the dynamic platform extension 18. The number of the stretching springs 15 may be multiple, the stretching springs 15 are uniformly distributed along the circumference of the main mobile robot static platform 11 or the circumference of the main robot dynamic platform 12, (preferably, 6, one ends of 3 of the 6 stretching springs 15 are respectively and one-to-one arranged at the positions of 3 groups of manual distance sensing push-pull rods, and one ends of the other 3 of the 6 stretching springs 15 are respectively and one-to-one arranged at the middle positions of two adjacent groups of manual distance sensing push-pull rods).
Because a plurality of devices need to be operated when the operator operates, in order to be beneficial to operation, the mapping switch is a foot switch, is arranged on the ground, can be operated to be opened or closed through foot actions (lifting or falling) of the operator, is connected with the central controller 2 and is used for opening or closing the conditional mapping between the master hand control robot 1 and the slave hand reset robot 2. The connection plug of the central controller 2 is preferably an aviation plug.
To further reduce the X-ray injury to the operator, the system further comprises: a lead screen 9 for separating the G-arm dual-display X-ray machine 6 from the operator. The patient side may be referred to as an operation area 91, and the slave hand reduction robot 3, the orthopedic operation table 4, the traction frame 5, and the G-shaped arm 61 are placed in the operation area 91. The operator side may be referred to as an operation area 92, and the main hand robot 1, the central controller 2, the console car 10, the console, the dual display 62, the foot switch 24, the recovery button 21, the extension button 22, and the shortening button 23 are placed in the operation area 92.
The following describes a method for performing a master-slave femoral shaft fracture reduction on a patient by using a master-slave femoral shaft fracture reduction parallel robot system. The method comprises the following steps: preoperative preparation steps and intraoperative manipulation steps.
The preoperative preparation steps specifically comprise: the master manipulator robot 1 and the central controller 2 are fixed to the console car 10. The robot is connected with the central controller 2 and the master hand control robot 1, the central controller 2 and the slave hand reset robot 3, and the central controller 2 and the mapping switch 1. The traction frame 5 and the orthopedic operation table 4 are connected into a rigid body, and in practice, the traction frame 5 and the orthopedic operation table 4 are mostly in the form of the same rigid body. The distal end fixing platform 31 of the slave hand-reset robot 3 is fixed to the traction frame 5. The patient with the fracture of the femoral shaft is laid on the orthopedic operating table 4, and the proximal femur 72 of the patient is fixed on the orthopedic operating table 4, so that the shin of the patient with the fracture takes a knee bending shape. Loosening a fixing bolt horizontally rotating on the traction frame 5 to enable the fixing bolt to freely move; the proximal moving platform 32 of the slave hand-reset robot 3 is aligned with the distal femur 71 of the patient 7 by adjusting the position of the traction frame 5 and the telescopic rocker handle thereon, and then the fixing bolt horizontally rotating on the traction frame is screwed; the distal femur 71 is secured to the proximal slave mobile robot 32 by a steel pin and bone pin; the position of the G-type arm 61 of the G-type arm double-display X-ray machine 6 is moved, and two groups of emitting and receiving devices of the G-type arm 61 are respectively aligned with the right position and the side position of the fracture of the femoral shaft.
The operation steps in the operation include: turning on a power switch of the central controller 2 and a power switch of the G-arm dual-display X-ray machine 6; observing the positive X-ray image and the lateral X-ray image displayed by the double display screen 62 of the G-arm double-display X-ray machine 6, controlling the dynamic platform of the main mobile phone robot of the main hand control robot 1, when the annular control handle 12 is arranged, controlling the handle, and conditionally mapping the fracture reduction operation of the main hand control robot 1 to the slave hand reduction robot 3 through the starting of the mapping switch 21 and the control of the central controller 2, so as to realize teleoperation of the slave hand reduction robot 3 to perform femoral shaft fracture reduction operation.
The following describes how the slave hand-reset robot 3 replicates the motion of the master hand-manipulated robot 1, taking the operation of rotating the right side of the ring in the horizontal plane inward, with the left side of the 2/3 ring of the slave hand-reset robot 3 as the center of the circle. The specific operation is as follows: and pulling out the right side of the dynamic platform of the master mobile phone robot of the master hand-operated robot, and keeping the slave hand-reset robot stationary if the mapping switch is not stepped on. And the pedal switch is stepped down, and the initial position of the right side of the dynamic platform of the main mobile phone robot of the main hand control robot is recovered. At this time, the slave hand-reset robot replicates the return motion of the master hand-manipulated robot.
It should be noted that: the mapping relationship is realized only when the foot switch is depressed, i.e. turned off. Otherwise, the mapping relation is not established. Therefore, when the mobile phone dynamic platform or the annular control handle of the master hand control robot is operated, the master mobile phone dynamic platform or the annular control handle of the master hand control robot can be adjusted to any position, and the slave hand reset robot is kept in a static state as long as the foot switch is not stepped. When the motion of the master hand-operated robot needs to be copied to the slave hand-reset robot, the foot switch is stepped on, and at the moment, the motion of the master hand-operated robot is copied to the slave hand-reset robot. Preferably, the proximal moving platform 32 of the slave hand-resetting robot 3 is in a two-thirds circular ring shape, in other words, the proximal moving platform has a third circular ring notch, the proximal moving platform is sleeved on the distal femur of the patient with knee bending through the third circular ring notch, and the distal femur is fixed on the proximal moving platform 32 of the slave hand-resetting robot through a steel needle and a bone nail.
In summary, the beneficial effects brought by the invention are as follows:
by establishing a mapping of the master hand manipulator robot 1 and the slave hand reset robot 2, X-ray injuries to medical staff are avoided or reduced.
The proximal moving platform of the robot reset by hand can maintain the posture unchanged under the static condition and has the same holding force as the reset operation, so that the manpower required by medical staff before fixing the fracture in order to keep the reset state after the fracture is reset is released.
By utilizing the characteristic that the orthopedic operation table 4 and the traction frame 5 are one rigid body, the distal end fixing platform 31 of the slave hand reduction robot 2 is fixed on the traction frame 5, so that the proximal femur end which is fixed on the orthopedic operation table 4 and the distal end fixing platform 31 which is fixed on the traction frame 5 are regarded as one rigid body, and when the proximal end moving platform 32 of the slave hand reduction robot performs fracture reduction motion, the distal femur end which is fixed on the proximal femur end and the distal femur end are driven to move simultaneously to realize fracture reduction, thereby being beneficial to the femoral reduction of patients.
It will be appreciated by those skilled in the art that the present invention can be carried out in other embodiments without departing from the spirit or essential characteristics thereof. Accordingly, the above disclosed embodiments are illustrative in all respects, and not exclusive. All changes that come within the scope of the invention or equivalents thereto are intended to be embraced therein.
Claims (6)
1. A master-slave femoral shaft fracture reduction parallel robot system, the system comprising: the system comprises a master hand control robot, a central controller, a slave hand reset robot, a mapping switch, an orthopedic operating table, a traction frame, a G-type arm double-display X-ray machine and an operation trolley; the main hand control robot is a manual push-pull rod six-degree-of-freedom parallel mechanism robot and is used for receiving and executing fracture reduction operation instructions of operators; the central controller is connected with the master hand-operated robot and the slave hand-reset robot and is used for conditionally mapping and transmitting fracture reset operation of the master hand-operated robot to the slave hand-reset robot; the mapping switch is connected with the central controller and is used for switching on or switching off conditional mapping operation of the central controller; the proximal femur end of a patient is fixed on the orthopedic operating table, and the patient is a patient with fracture of the femoral shaft and is in a knee bending posture; the traction frame and the orthopedic operating table are connected into a rigid body; the slave hand resetting robot is an electric push-pull rod six-degree-of-freedom parallel mechanism robot, and a remote fixing platform of the slave hand resetting robot is fixed on the traction frame;
The proximal end moving platform of the slave hand-operated robot is used for fixing the distal femur end of a patient through bone nails or bone pins and copying fracture reduction operation of the master hand-operated robot on the patient under the mapping control of the central controller;
Pressing a mapping switch, and transmitting the fracture reduction operation mapping of the master hand control robot to the slave hand reduction robot by the central controller; when the mapping switch is released, the central controller does not transmit the operation mapping of the master hand control robot to the slave hand reset robot;
The G-type arm double-display X-ray machine is used for simultaneously collecting an orthotopic X-ray image and a lateral X-ray image of a fracture position of a femoral shaft of a patient; the main hand control robot and the central controller are fixed on the operation trolley; wherein the fracture reduction operation instruction is made by an operator according to the observed orthotopic X-ray image and the lateral X-ray image;
The master hand-operated robot includes: the mobile phone comprises a main mobile phone robot static platform, a main mobile phone robot dynamic platform, six manual distance sensing push-pull rods and six pairs of universal joints; the main mobile phone robot static platform is disc-shaped and is fixed on the operation trolley; the main mobile phone robot dynamic platform is disc-shaped and is used for receiving fracture reduction operation instructions of the operator; six manual distance sensing push-pull rods are positioned between the main mobile phone robot static platform and the main mobile phone robot dynamic platform; the universal joints are used for connecting two end parts of one manual distance sensing push-pull rod with the corresponding main mobile phone robot static platform and the corresponding main mobile phone robot dynamic platform respectively;
The master hand-operated robot further includes: a tension spring; the extension spring is connected between the main mobile phone robot static platform and the main mobile phone robot dynamic platform and is positioned on the outer side of the circumference of the main mobile phone robot static platform and the circumference of the main mobile phone robot dynamic platform.
2. The system of claim 1, wherein the slave hand reset robot comprises: the device comprises a far-end fixed platform, a near-end movable platform, six electric push-pull rods and six pairs of universal joints; the far-end fixing platform is disc-shaped; the near-end moving platform is in a two-thirds circular shape; six electric push-pull rods are connected between the far-end fixed platform and the near-end movable platform through six pairs of universal joints and used for executing corresponding actions under the mapping control of the central controller; the universal joints are used for connecting two end parts of an electric push-pull rod with the corresponding far-end fixed platform and the corresponding near-end movable platform respectively.
3. The system of claim 2, wherein the central controller is further configured to directly control the stroke of the electric push-pull rod; the system further comprises: a recovery key, an extension key and a shortening key which are respectively connected with the central controller; the recovery key is used for recovering the electric push-pull rod from the current stroke to half of the rated stroke; the extension key is used for gradually extending the electric push-pull rod from the current stroke; the shortening key is used for gradually shortening the electric push-pull rod from the current stroke.
4. The system of claim 1 or 2, wherein the universal joint is a flexible universal joint.
5. The system of claim 1, wherein the mapping switch is a foot switch, the foot switch being disposed on the ground.
6. The system of claim 1, wherein the system further comprises: and the lead screen is arranged between the G-type arm double-display X-ray machine and the operator.
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| CN107811797B (en) * | 2017-11-10 | 2023-09-26 | 中国人民解放军总医院 | Orthopedics robot |
| US10842699B2 (en) * | 2018-04-27 | 2020-11-24 | Ormonde M. Mahoney | System and method for patient positioning in an automated surgery |
| CN109330686B (en) * | 2018-10-25 | 2021-06-04 | 上海大学 | Robot-assisted reduction system for long bone fracture |
| CN109498141B (en) * | 2018-11-20 | 2024-04-02 | 中国人民解放军第四军医大学 | Master-slave double-arm bionic digital long bone diaphysis fracture reduction robot |
| CN109480980B (en) * | 2019-01-05 | 2024-05-07 | 陈聚伍 | Multi-dimensional flexible fracture reduction device |
| CN109771196A (en) * | 2019-01-23 | 2019-05-21 | 上海莱影医疗科技有限公司 | A kind of reduction of the fracture system and method |
| CN110141335B (en) * | 2019-04-14 | 2024-04-26 | 浙江工业大学 | Triangular telescopic skeleton rehabilitation external fixation frame |
| CN111685880B (en) | 2020-05-18 | 2021-08-31 | 天津大学 | Wearable fracture reduction and rehabilitation integrated robot |
| CN112043384B (en) * | 2020-07-29 | 2023-07-18 | 上海大学 | External force prediction system of fracture reduction robot |
| CN112828862B (en) * | 2020-12-30 | 2022-09-16 | 诺创智能医疗科技(杭州)有限公司 | Master-slave mapping method for parallel platform, mechanical arm system and storage medium |
| CN113907882A (en) * | 2021-08-26 | 2022-01-11 | 四川大学华西医院 | A location robot resets for fracture operation |
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