School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai, China.
Department of Orthopedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
Comput Biol Med. 2021 Jun;133:104402. doi: 10.1016/j.compbiomed.2021.104402. Epub 2021 Apr 15.
The distal interlocking of intramedullary nail remains a technically demanding procedure. Existing augmented reality based solutions still suffer from hand-eye coordination problem, prolonged operation time, and inadequate resolution. In this study, an augmented reality based navigation system for distal interlocking of intramedullary nail is developed using Microsoft HoloLens 2, the state-of-the-art optical see-through head-mounted display.
A customized registration cube is designed to assist surgeons with better depth perception when performing registration procedures. During drilling, surgeons can obtain accurate and in-situ visualization of intramedullary nail and drilling path, and dynamic navigation is enabled. An intraoperative warning system is proposed to provide intuitive feedback of real-time deviations and electromagnetic disturbances.
The preclinical phantom experiment showed that the reprojection errors along the X, Y, and Z axes were 1.55 ± 0.27 mm, 1.71 ± 0.40 mm, and 2.84 ± 0.78 mm, respectively. The end-to-end evaluation method indicated the distance error was 1.61 ± 0.44 mm, and the 3D angle error was 1.46 ± 0.46°. A cadaver experiment was also conducted to evaluate the feasibility of the system.
Our system has potential advantages over the 2D-screen based navigation system and the pointing device based navigation system in terms of accuracy and time consumption, and has tremendous application prospects.
髓内钉远端锁定仍然是一项技术要求很高的操作。现有的基于增强现实的解决方案仍然存在手眼协调问题、操作时间延长和分辨率不足的问题。本研究使用 Microsoft HoloLens 2（最先进的光学透视头戴式显示器）开发了一种基于增强现实的髓内钉远端锁定导航系统。
设计了一个定制的配准立方体，以帮助外科医生在进行配准手术时获得更好的深度感知。在钻孔过程中，外科医生可以获得准确的、原位的髓内钉和钻孔路径可视化，并实现动态导航。提出了一种术中警告系统，以提供实时偏差和电磁干扰的直观反馈。
临床前的幻影实验表明，沿 X、Y 和 Z 轴的重投影误差分别为 1.55±0.27mm、1.71±0.40mm 和 2.84±0.78mm。端到端评估方法表明，距离误差为 1.61±0.44mm，3D 角度误差为 1.46±0.46°。还进行了尸体实验以评估该系统的可行性。
与基于 2D 屏幕的导航系统和基于指点设备的导航系统相比，我们的系统在准确性和时间消耗方面具有潜在的优势，具有巨大的应用前景。
