Surgical Robotic System for Precision Femoral Fracture Reduction

Malalignment after femoral fracture repair remains common, with up to one-third of patients experiencing malrotations. Manual femoral fracture reduction remains physically demanding and fluoroscopy-dependent. Surgeons must apply traction forces to overcome forces generated by the surrounding muscles during the reduction process. Current orthopaedic robots, designed primarily for arthroplasty or spine procedures, generally cannot deliver the high traction or torque required for long-bone manipulation. To address the need for controlled high-force manipulation during femoral fracture reduction and to reduce reliance on fluoroscopy for assessing alignment, we developed a novel surgical robotic system. The system combines a 6-degrees-of-freedom (6-DOF) parallel mechanism with a high load capacity, an optical tracking system that provides continuous pose feedback, and a gauge-based graphical interface that displays translational and angular offsets between bone fragments and the target alignment. The system is intended to provide controlled application of clinically relevant traction and torque during femoral fracture reduction. These capabilities reduce reliance on sustained manual traction and support reduction maneuvers that are more repeatable, potentially improving intraoperative alignment consistency and procedural workflow. Future work will focus on hardware and software updates to improve operating-room integration and to expand the usable workspace. It will evaluate the use of artificial intelligence (AI)-assisted registration and 3D visualization to support alignment assessment and automated alignment workflows.