Dogramadzi, S., Raabe, D. and Atkins, R. and Withers&Rogers LLP
A system for anatomical reduction of bone fractures.
University of the West of England.
Available from: http://eprints.uwe.ac.uk/16054
For optimum healing of bone fractures in the human body, to ensure that the bone and surrounding joints are able to function correctly again, the fragments of the broken bone must be subjected to an anatomical reduction, which involves positioning and aligning the fragments of the broken bone to reconstruct the fractured bone as precisely as possible, so that the bone recovers to a form as close as possible to its original form as it heals.
This anatomical reduction may be performed by open surgery, in which large incisions are made in flesh around the affected joint and the bone fragments are manipulated by a surgeon to reposition and realign them as precisely as possible. Whilst this technique can be effective, it has disadvantages. For example, the anatomical reduction is not always perfect, in that the bone fragments are not always perfectly positioned or aligned. This leads to imperfect healing and can cause arthritis later in the patient’s life. Additionally, the extensive exposure required by the open surgery procedure typically slows bone healing and produces unsightly scars, as well as giving rise to an increased risk of infection. A prolonged period of post-operative rehabilitation is required, which requires the patient to endure an extended stay in hospital.
In order to mitigate the disadvantages of open surgery techniques, minimally invasive percutaneous procedures have been developed. These techniques involve sequentially
fixating and manipulating each bone fragment manually, without making large incisions in the patient’s flesh. Such techniques are associated with a faster recovery and a lower risk of infection compared to open surgery techniques. However, minimally invasive techniques may involve lower reduction accuracy, and in some cases the reduction accuracy is less than the minimum accuracy (typically <1mm translationally and <5 degrees rotationally) required for optimum clinical outcomes. Moreover, minimally invasive procedures require multiple radiographic images of the patient to be taken during the surgical procedure to ensure that the bone fragments are being correctly positioned and orientated during the procedure. This exposes the patient and medical staff to undesirably high levels of radiation. Notwithstanding these multiple radiographic images, fragment reduction remains sub-optimal.
Accordingly, a need exists for a system which improves the level of reduction accuracy of minimally invasive surgical techniques and reduces exposure to radiation, whilst retaining the recovery speed and low infection risk of existing minimally invasive techniques.
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