In minimally invasive surgery, maneuverability is usually limited and a large number of degrees of freedom (DOF) is highly demanded. However, increasing the DOF usually means increasing the complexity of the surgical instrument leading to long fabrication and assembly times. In this work, we propose the first fully 3D printed handheld, multi-steerable device. The proposed device is mechanically actuated, and possesses five serially controlled segments. We designed a new compliant segment providing high torsion and axial stiffness as well as a low bending stiffness by merging the functions of four helicoids and a continuum backbone. Compliant segments were combined to form the compliant shaft of the new device. In order to control this compliant shaft, a control handle was designed that mimics the shaft structure. A prototype called the HelicoFlex was built using only three 3D printed parts. HelicoFlex, with its 10 degrees of freedom, showed a fluid motion in performing single and multi-curved paths. The multi-steerable instrument was 3D printed without any support material in the compliant shaft itself. This work contributes to enlarge the body of knowledge regarding how additive manufacturing could be used in the production of multi-steerable surgical instruments for personalized medicine.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7224500 | PMC |
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0232952 | PLOS |
Eur J Orthop Surg Traumatol
January 2025
Department of Orthopaedic Surgery, University of California San Diego, 200 West Arbor Drive MC 8894, San Diego, CA, 92103, USA.
Purpose: While treatment modalities for Maisonneuve fractures involving the proximal third of the fibula are established, no studies to date have reported outcomes associated with syndesmotic-only fixation of middle third fibular shaft fractures. The purpose of this study was to evaluate outcomes associated with syndesmotic-only fixation in the treatment of Maisonneuve fractures involving the middle third of the fibula.
Methods: A retrospective review was conducted on 257 cases of syndesmotic ankle instability with associated fibular fractures at a level 1 trauma center between 2013 and 2023.
Cureus
November 2024
Information Technology, Mandayam Osuri Parthasarathi Vaishnav College for Women, Chennai, IND.
Introduction: Intramedullary interlocking nailing is a common surgical procedure for tibial fractures, enabling early patient mobilization. Traditionally, the infrapatellar approach has been used for intramedullary interlocking nailing of tibial fractures, but the suprapatellar approach is gaining attention for its potential benefits. This randomized controlled study aimed to compare the duration of the surgery, intra-operative blood loss, and fluoroscopy time between the suprapatellar and infrapatellar approaches.
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November 2024
Department of Orthopedics, Royal Berkshire NHS Foundation Trust, Reading, GBR.
Neurovascular complications associated with clavicular shaft fractures can manifest at presentation, develop gradually over time, or potentially be iatrogenically induced. Conducting a thorough neurovascular examination and, when warranted, pursuing further investigation through modalities such as CT angiogram, MRI, and nerve conduction studies (NCS) are crucial for early diagnosis and pre-operative planning. This comprehensive approach enhances patient outcomes by facilitating timely intervention and addressing any underlying neurovascular issues associated with the fracture.
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November 2024
Orthopaedic Department, General Hospital of Ioannina "G. Hatzikosta", Ioannina, GRC.
Hypertrophic non-union, after an isolated fibular fracture with intact tibia, is an extremely uncommon complication. The aim of the current study is to present an infrequent case of hypertrophic non-union after an isolated fracture in the proximal diaphysis of fibula which was treated surgically. A 23-year-old male patient presented to our hospital with persistent pain on the lateral aspect of his right leg.
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November 2024
Orthopaedic Surgery, University of Puerto Rico, Medical Sciences Campus, San Juan, USA.
Atypical fractures are diagnosed when an otherwise normal force causes a fracture in a patient using bisphosphonates chronically. These occur most commonly in the subtrochanteric region of the femur. Yet, the literature on atypical tibial shaft fractures is scarce.
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