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Background: Handheld surgical robots offer functionalities, such as active guidance, tremor suppression and force reflection, for surgeons to enhance their skill in manipulating surgical tools during medical intervention. In orthopedic surgery, the robot additionally has to offer sufficient rigidity and power for bone machining. The size and weight of the mechanical design, together with the control behaviour associated with involuntary hand motion, navigation and reflected force to the human, all influence the overall performance of an orthopedic handheld robot., Methods: The paper proposes a miniature and compact design for an embedded robot, which is a similar weight as a handpiece. Then, a shared controller is proposed to address the coupling among involuntary and voluntary hand motions, robot navigation, tool feedback forces and force artefacts from actuation., Results: The handheld robot is able to stabilize the drill positioning by removing involuntary tremors as well as reduce force artefacts from motor actuation in experiments involving pedicle tunnelling on a porcine spine., Conclusion: The paper has successfully realized a compact handheld orthopedic robot which provides high performance of usability, tremor suppression and force reflection for bone drilling., (© 2021 John Wiley & Sons Ltd.)

Sixty-two reducible trigger thumbs in 50 children with age from 0 to 4 years (mean, 1 year 11 months) were reviewed to study the effect of splinting. Thirty-one thumbs in 24 children received splinting for a mean of 11.7 weeks. The other 31 thumbs in 26 children were only observed. The results were categorized as cured, improved, or nonimproved. Follow-up was conducted after a mean of 20 months (age, 43 months). Result in the splinted group showed cured in 12 thumbs, improved in 10 thumbs, and nonimproved in 9 thumbs, whereas in the observed group, result showed 4, 3, and 24, respectively. Splinting results in 71% trigger thumbs cured or improved that is better than observation alone. The subsequent surgical release for the nonimproved trigger thumbs after splinting still had excellent results. Because surgical release for trigger thumb is not urgent, we suggest extension splinting to be a treatment option before the elective surgery.