A new fluoroscopy-free navigation device for distal interlocking screw placement
Journal
Journal of Medical Engineering and Technology
Journal Volume
32
Journal Issue
4
Pages
284-295
Date Issued
2008
Author(s)
Abstract
During the treatment of tibia fracture with interlocking nails, the most uncomfortable procedure is for an orthopaedic surgeon to find the location for the distal locking screws. In this study, a fluoroscopy-free non-contact navigation device was developed for the placement of distal locking screws in the tibia intramedullary nailing. This device utilizes a 3D digitization arm integrated with spatial coordinate registration module, graphical user interface module and sound-guided navigation module. The 3D digitization arm, a five-DOF passive robotic arm, was used to register the spatial coordinates of proximal and distal landmarks just before placement of the nail. The registered coordinates were then incorporated with the coordinates of the proximal landmarks after nail placement to calculate the coordinate transformation matrix. The transformed spatial coordinates of the distal screw holes were then computed in real time for interlocking nail navigation. A sound-guided navigation module was designed in which a sound with different tones and intermittence frequencies was produced, as the probe of the digitization arm navigates toward the location of distal screw holes. No intra-operative fluoroscopy was required. In vitro assessment was performed successfully with a donor bone, and a clinical case of a young male with tibia fracture was also carried out in the operating theatre. Operation time, distal screw insertion, total radiation time and accuracy of the distal interlocking screw placement were measured. The surgery was conducted under sterile conditions without complication, and the clinical course was smooth with prompt bone healing. ? 2008 Informa UK Ltd.
Subjects
Bone
Computer systems
Fasteners
Fluorescent screens
Fracture fixation
Graphical user interfaces
Health
Screws
Surgery
3D digitization
Bone healing
Clinical courses
Co ordinate transformation
Distal locking
Guided navigation
In-vitro
Interlocking nails
Intra-operative
Intramedullary
Noncontact (NC)
Operating theatres
Operation time
Real time
Spatial coordinates
Sterile conditions
UK Ltd. (CO)
Navigation
adult
article
bone screw
case report
clinical trial
computer aided design
computer program
controlled study
device
disease course
fluoroscopy
fracture healing
human
in vitro study
interlocking nail
intramedullary nailing
male
operation duration
quantitative analysis
robotics
sound detection
surgical technique
tibia fracture
Bone Screws
Equipment Design
Equipment Failure Analysis
Fluoroscopy
Fracture Fixation, Internal
Humans
Imaging, Three-Dimensional
Prosthesis Implantation
Robotics
Surgery, Computer-Assisted
Tibial Fractures
SDGs
Type
journal article