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Special Section Technical Briefs

Feedback Control for Patient Specific Limb Lengthening and Limb Deformity Correction1

[+] Author and Article Information
Janine Guenther, Daniel Farley, Heidi-Lynn Ploeg, Michael Zinn

Department of Mechanical Engineering,
University of Wisconsin–Madison,
Madison, WI 53706

Accepted and presented at The Design of Medical Devices Conference (DMD2015), April 13–16, 2015, Minneapolis, MN, USA.

Manuscript received March 3, 2015; final manuscript received May 7, 2015; published online July 16, 2015. Editor: Arthur Erdman.

J. Med. Devices 9(3), 030904 (Sep 01, 2015) (2 pages) Paper No: MED-15-1059; doi: 10.1115/1.4030595 History: Received March 03, 2015; Revised May 07, 2015; Online July 16, 2015

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References

Paley, D., 2000, “Correction of Limb Deformities in the 21st Century,” J. Pediatr. Orthop., 20(3), pp. 279–281 http://journals.lww.com/pedorthopaedics/Fulltext/2000/05000/Correction_of_Limb_Deformities_in_the_21st_Century.1.aspx. [PubMed]
Paley, D., 1990, “Problems, Obstacles, and Complications of Limb Lengthening by the Ilizarov Technique,” Clin. Orthop. Relat. Res., 250, pp. 81–104 http://journals.lww.com/corr/Fulltext/1990/01000/Problems,_Obstacles,_and_Complications_of_Limb.11.aspx. [PubMed]
Tjernström, B., Olerud, S., and Rehnberg, L., 1994, “Limb Lengthening by Callus Distraction. Complications in 53 Cases Operated 1980-1991,” Acta Orthop. Scand., 65(4), pp. 447–455. [CrossRef] [PubMed]
Emara, K., Farouk, A., and Diab, R., 2011, “Ilizarov Technique of Lengthening and Then Nailing for Height Increase,” J. Orthop. Surg., 19(2), pp. 204–208.
Rogers, L. C., Bevilacqua, N. J., Frykberg, R. G., and Armstrong, D. G., 2007, “Predictors of Postoperative Complications of Ilizarov External Ring Fixators in the Foot and Ankle,” J. Foot Ankle Surg., 46(5), pp. 372–375. [CrossRef] [PubMed]
Iosbt, C., 2014, “Pin Track Infections: Somewhere Between 0 and 100%,” 24th Annual Scientific Meeting, Limb Lengthening and Reconstruction Society, Quebec, Canada, July 25–26.
Rozbruch, S. R., and Ilizarov, S., 2013, Limb Lengthening and Reconstruction Surgery, Taylor & Francis, Boca Raton, FL.
Schiedel, F. M., Vogt, B., Tretow, H. L., Schuhknecht, B., Gosheger, G., Horter, M. J., and Rödl, R., 2014, “How Precise is the PRECICE Compared to the ISKD in Intramedullary Limb Lengthening?,” Acta Orthop., 85(3), pp. 293–298. [CrossRef] [PubMed]
Farley, D. P., Ploeg, H., and Zinn, M., 2014, “Towards a Novel, Implantable Limb Lengthening Device,” ASME J. Med. Devices, 8(2), p. 020939. [CrossRef]
Lauterburg, M. T., Exner, G. U., and Jacob, H. A. C., 2006, “Forces Involved in Lower Limb Lengthening: An In Vivo Biomechanical Study,” J. Orthop. Res., 24(9), pp. 1815–1822. [CrossRef] [PubMed]
Ohnishi, I., Kurokawa, T., Sato, W., and Nakamura, K., 2005, “Measurement of the Tensile Forces During Bone Lengthening,” Clin. Biomech., 20(4), pp. 421–427. [CrossRef]
Gardner, T., Evans, M., Simpson, H., and Kenwright, J., 1998, “Force-Displacement Behaviour of Biological Tissue During Distraction Osteogenesis,” Med. Eng. Phys., 20(9), pp. 708–715. [CrossRef] [PubMed]

Figures

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Fig. 1

System model of implantable device attached to SLS tissue model showing stepper motor rotor inertia (Im), device mass (md), and displacement ratio (N). The motor produces torque (τm), which results in device displacement (xd) and force feedback (fc).

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Fig. 2

Position and force responses for sudden changes in tissue stiffness. At time 1, the system becomes 50% more stiff, at time 2 the system become 50% more pliant, and at time 3, the system become 70% more pliant.

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Fig. 3

Improved control approach in which force is monitored to detect complications during lengthening and the trajectory of the position command is adjusted to compensate for changes in system stiffness. As the device is motor driven, a continuous position command can be supplied to avoid high peak forces associated with position steps.

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