Advancing computer-assisted orthopaedic surgery using a hexapod device for closed diaphyseal fracture reduction

Background: Surgical complications such as healing problems, in fractures treated using the Arbeitsgemeinschaft für Osteosynthesefragen (AO) technique, present functional and economic challenges to patients and treatment dilemmas for surgeons. Computer-assisted orthopaedic surgery using minimally invasive techniques focused on biological osteosynthesis is a novel direction for fracture treatment. Method: We modified the hexapod computer-assisted fracture reduction system by introducing a new reduction strategy, building a new system configuration and upgrading the corresponding software. We then validated the entire system, using a fracture model of bovine femur. Results: Precision tests were performed seven times on a bovine femur with a transverse fracture. Residual deviation was 1.23±0.60mm in axial deflection, 1.04±0.47mm in translation, 2.34±1.79° in angulation and 2.83±0.96° in rotation. Conclusion: Our new reduction system described here is detachable, flexible and more precise in coordinate transformations. The detachable, modular design will allow for more analogous applications in the future.