Ma Longfei, Zhao Zhe, Zhang Boyu, Jiang Weipeng, Fu Ligong, Zhang Xinran, Liao Hongen
Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China.
Department of Orthopedics Surgery, Beijing Tsinghua Changgung Hospital, Beijing, China.
Int J Med Robot. 2018 Aug;14(4):e1909. doi: 10.1002/rcs.1909. Epub 2018 Mar 25.
Intramedullary nail (IMN) fixation improves functional outcomes for the diaphyseal fractures of long bones. However, locking the distal holes of the IMN is challenging. Although several navigation methods have been proposed, an intuitive, radiation-free and accurate navigation method that does not suffer from problems of hand-eye coordination has not yet been described.
This paper proposes an augmented reality (AR) surgical navigation method with hybrid optical and electromagnetic (EM) tracking for distal IMN interlocking. Model experiments are designed to evaluate the AR-guided distal interlocking method.
AR-guided drilling procedures were performed on 5 tibia models and a leg phantom. The accuracy (hit or miss) was evaluated using fluoroscopy. The experimental results demonstrated that all 18 drills successfully hit the distal holes at a rate of 100%.
Our results indicate that the AR-guided distal interlocking method is feasible and has many potential applications in clinic after further evaluation.
髓内钉（IMN）固定可改善长骨干骨折的功能预后。然而，锁定髓内钉的远端孔具有挑战性。尽管已经提出了几种导航方法，但尚未描述一种直观、无辐射且准确的导航方法，该方法不存在手眼协调问题。
本文提出了一种用于远端髓内钉交锁的混合光学和电磁（EM）跟踪的增强现实（AR）手术导航方法。设计模型实验以评估AR引导的远端交锁方法。
在5个胫骨模型和1个腿部模型上进行了AR引导的钻孔操作。使用荧光透视评估准确性（命中或未命中）。实验结果表明，所有18次钻孔均成功命中远端孔，成功率为100%。
我们的结果表明，AR引导的远端交锁方法是可行的，经过进一步评估后在临床上有许多潜在应用。
