A novel smart navigation system for intramedullary nailing in orthopedic surgery

This paper proposes a novel smart surgical navigation system for intramedullary nailing in orthopedic surgery. Using a handle-integrated laser guidance module, the system can target a drill insertion point onto skin, indicating an accurate target position to perpendicularly access an invisible distal hole. The proposed handle-integration-based fixation of the laser guidance module precisely defines the relative position of the module with respect to the distal hole. Consequently, unlike conventional systems, the proposed system can indicate the target insertion point without any help from bulky and costly external position-tracking equipment that is usually required for compensating disturbances generated by external impacts. After insertion, a correct drilling direction toward the distal hole is guided by real-time drilling angle measurement modules–one integrated with the nail handle and the other with the drill body. Each module contains a 9-axis inertial sensor and a Bluetooth communication device. These two modules work together to provide real-time drilling angle data, allowing calculation of the directional error toward the center of the distal hole in real time. The proposed system removes the need for fluoroscopy and provides a compact and cost-effective solution compared with conventional systems.

本论文提出一种用于骨科手术髓内钉固定术的新型智能手术导航系统。该系统采用手柄集成式激光引导模块，可将钻头插入点定位至皮肤表面，为垂直定位不可见的远端锁孔提供精准目标位置。本研究提出的基于手柄集成方式的激光引导模块固定方案，可精准确定该模块相对于远端锁孔的相对位置。因此，与传统导航系统不同，本系统无需借助传统系统通常所需的笨重且昂贵的外部位置跟踪设备（此类设备用于补偿外部冲击产生的干扰），即可指示目标插入点。在钻头插入后，系统可通过实时钻头角度测量模块引导朝向远端锁孔的正确钻孔方向：其中一个模块集成于髓内钉手柄，另一个集成于钻体。每个模块均搭载9轴惯性传感器与蓝牙通信设备。双模块协同工作以提供实时钻头角度数据，可实时计算朝向远端锁孔中心的方向偏差。本系统无需使用放射透视设备，且相较于传统系统，具备结构紧凑、成本效益突出的优势。