18th May 2010
An engineer at the University of the West of England is working
with an orthopaedic surgeon from the Bristol Royal Infirmary and a
specialized software company to enhance the management of complex,
joints' fractures by creating a robotics device that can put the
fractures back together as perfectly as possible, using the state
of the art of 3D imaging, pattern recognition and robotics.
Dr Sanja Dogramadzi, an engineer from Bristol Robotics
Laboratory at the University of the West of England, will use CT
scans of healthy and fractured joints to work out the mathematical
algorithm for the exact displacement and rotation needed for each
fragment to be put back together in exactly the right place. The 3D
puzzle solution will be a starting point for creating a minimally
invasive surgical robotic system. The work will be carried out in
consultation with Professor Roger Atkins (Orthopaedic Surgeon at
Bristol Royal Infirmary) using the 3D imaging software by
Simpleware. (http://www.simpleware.com)
A further phase of the work will create a robotic device which
will test the 3D puzzle by putting all the broken pieces back
together on a 3D model, created with specialized print technology
from UWE's Centre for Fine Print Research. Ultimately it is hoped
the research will lead to a robotic device which will be able to
perform the minimally invasive surgery using the information from
the CT scans, under the expert control of a surgeon.
Dr Sanja Dogramadzi explains, The idea for this project came
from a series of discussions with Dr Milan Bates and Professor
Roger Atkins from BRI. In complex breaks, particularly joints,
there are often many surfaces to the broken bone. Getting these to
fit back together accurately (reduction) is essential for the
healing process. Currently this can be solved by using open
surgery, where the break is exposed and the surgeon then
manipulates the bone so it fits together accurately. However, a 3D
puzzle of the broken bone, made using the information from the CT
scan, would give clinicians a more accurate understanding of what
they need to do, before surgery needed to take place. At the
moment, even in open surgery, all the surfaces of the break are not
visible to the surgeon.
Using the technology of the Centre for Fine Print Research,
presented to us by Dr Peter Walters, we have already been able to
create a 3D model of a bone fracture from a CT scan. Another use of
this technology may be to create models of these complex breaks
which may be used in training doctors to help their understanding
of bone displacement and shapes. The ultimate aim of our research
will be to create a robot which can use the 3D puzzle model to
carry out bone reductions using minimally invasive surgery (keyhole
surgery).
If successful we hope that this project would create better
outcomes for patients. More accurate reductions without the need
for open surgery means patients will heal faster with fewer
complications and less need for follow up appointments. We are
looking forward to developing this research with our
collaborators.
Professor Roger Atkins says, We were impressed with the 3D model
that was produced by UWE, using a CT scan and the 3D print
technology. It was fascinating for me, even with all my years of
experience, to see an accurate 3D model of a break. This research
could be a new departure for us in the way that complex breaks are
fixed. It would give us all the information - and more -
that we get from open surgery, but without the risks that
represents. Currently the non-invasive methods, key hole surgery,
don't have the depth of information that this research will give
us. We are looking forward to working with UWE to develop this
research.
The project entitled: Robotic reduction of complex fractures
using 3D puzzle solving algorithm' is being funded by an
Engineering and Physical Sciences Research Council (EPSRC) grant
worth: £97,176. (http://epsrc.ac.uk/)
