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      KCI등재 SCOPUS

      최소침습 골절정복 수술에서 나사못 삽입 경로를 유도하는 시스템 = Locking Screw Insertion Path Guidance System in Minimally Invasive Fracture Reduction Surgery

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      https://www.riss.kr/link?id=A108578294

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      다국어 초록 (Multilingual Abstract)

      In this paper, we propose a system to detect the location and direction of locking screw insertion using only a fluoroscopic image and guide screw insertion path, with a device that combines a SCARA robot arm and a conical remote center-of-motion (RCM) mechanism. In the proposed system, the target location and direction for screw insertion were derived from the fluoroscopic image of an intramedullary nail. The insertion guidance device comprise the SCARA robot arm and the RCM mechanism. The insertion guidance device calculated the current indicated path through forward kinematics analysis, and the target path and the current path were transmitted to the orthopedic surgeon through the control program. Moreover, the insertion guidance device set the insertion position and direction independently. The orthopedic surgeon first adjusted the SCARA robot arm to match the insertion position value to the target value and then sequentially adjusted the RCM mechanism so that the insertion direction matched the target value. After determining the insertion position and direction, the orthopedic surgeon inserted the surgical instrument through the path guided by the insertion guidance device and fastened the screw to the bone fragments and the intramedullary nail. When the proposed screw insertion guidance system was applied to fracture surgery, the locking screw was fastened with a minimum number fluoroscopic image, thus reducing surgery time and radiation exposure. The validity of the proposed method was confirmed through simulations and experiments using a fracture model.
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      In this paper, we propose a system to detect the location and direction of locking screw insertion using only a fluoroscopic image and guide screw insertion path, with a device that combines a SCARA robot arm and a conical remote center-of-motion (RCM...

      In this paper, we propose a system to detect the location and direction of locking screw insertion using only a fluoroscopic image and guide screw insertion path, with a device that combines a SCARA robot arm and a conical remote center-of-motion (RCM) mechanism. In the proposed system, the target location and direction for screw insertion were derived from the fluoroscopic image of an intramedullary nail. The insertion guidance device comprise the SCARA robot arm and the RCM mechanism. The insertion guidance device calculated the current indicated path through forward kinematics analysis, and the target path and the current path were transmitted to the orthopedic surgeon through the control program. Moreover, the insertion guidance device set the insertion position and direction independently. The orthopedic surgeon first adjusted the SCARA robot arm to match the insertion position value to the target value and then sequentially adjusted the RCM mechanism so that the insertion direction matched the target value. After determining the insertion position and direction, the orthopedic surgeon inserted the surgical instrument through the path guided by the insertion guidance device and fastened the screw to the bone fragments and the intramedullary nail. When the proposed screw insertion guidance system was applied to fracture surgery, the locking screw was fastened with a minimum number fluoroscopic image, thus reducing surgery time and radiation exposure. The validity of the proposed method was confirmed through simulations and experiments using a fracture model.

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      참고문헌 (Reference)

      1 ANLIMING ; 김우영 ; 고성영, "광학식측정장치를 이용한 금속정 내고정 수술의 원위부 나사체결을 위한 로보틱 유도 시스템" 한국로봇학회 12 (12): 411-418, 2017

      2 백준민 ; 노건우 ; 서준호, "광학식 무선 위치 추적 장치의 개발과 성능 검증" 제어·로봇·시스템학회 25 (25): 1065-1070, 2019

      3 김지완 ; 김정재, "골절 치료 시 정형외과 의사에 대한 방사선 노출" 대한정형외과학회 45 (45): 107-113, 2010

      4 "https://consopharma.com/a-brief-overview-of-intramedullarynailing/"

      5 Zimmer Biomet, "Zimmer Natural Nail System Cephalomedullary Nail Surgical Technique, rev. 7"

      6 N. S. Blake, "The use of robotics in minimally invasive spine surgery" 5 (5): 31-40, 2019

      7 T. H. Wong, "Novel passive two-stage magnetic targeting devices for distal locking of interlocking nails" 2017

      8 M. S. Rashid, "Intra-operative fluoroscopic radiation exposure in orthopaedic trauma theatre" 28 (28): 9-14, 2018

      9 T. Doke, "Fluoroscopy-based laser guidance system for linear surgical tool insertion depth control" 10 (10): 275-283, 2015

      10 T. H. Wong, "Electromagnetic/Magnetic-coupled targeting system for screw-hole locating in intramedullary interlocking-nail surgery" 14 (14): 4402-4410, 2014

      1 ANLIMING ; 김우영 ; 고성영, "광학식측정장치를 이용한 금속정 내고정 수술의 원위부 나사체결을 위한 로보틱 유도 시스템" 한국로봇학회 12 (12): 411-418, 2017

      2 백준민 ; 노건우 ; 서준호, "광학식 무선 위치 추적 장치의 개발과 성능 검증" 제어·로봇·시스템학회 25 (25): 1065-1070, 2019

      3 김지완 ; 김정재, "골절 치료 시 정형외과 의사에 대한 방사선 노출" 대한정형외과학회 45 (45): 107-113, 2010

      4 "https://consopharma.com/a-brief-overview-of-intramedullarynailing/"

      5 Zimmer Biomet, "Zimmer Natural Nail System Cephalomedullary Nail Surgical Technique, rev. 7"

      6 N. S. Blake, "The use of robotics in minimally invasive spine surgery" 5 (5): 31-40, 2019

      7 T. H. Wong, "Novel passive two-stage magnetic targeting devices for distal locking of interlocking nails" 2017

      8 M. S. Rashid, "Intra-operative fluoroscopic radiation exposure in orthopaedic trauma theatre" 28 (28): 9-14, 2018

      9 T. Doke, "Fluoroscopy-based laser guidance system for linear surgical tool insertion depth control" 10 (10): 275-283, 2015

      10 T. H. Wong, "Electromagnetic/Magnetic-coupled targeting system for screw-hole locating in intramedullary interlocking-nail surgery" 14 (14): 4402-4410, 2014

      11 C. Krettek, "Deformation of Femoral Nails with Intramedullary Insertion" 16 (16): 572-575, 1998

      12 R. A. Winquist, "Closed intramedullary nailing of femoral fractures. A report of five hundred and twenty cases" 66 (66): 529-539, 1984

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