The 'augmented' circles: A video-guided solution for the down-the-beam positioning of im nail holes

Roberto Londei, Marco Esposito, Benoit Diotte, Simon Weidert, Ekkehard Euler, Peter Thaller, Nassir Navab, Pascal Fallavollita

Research output: Chapter in Book/Report/Conference proceedingConference contributionpeer-review

9 Scopus citations

Abstract

Intramedullary nailing is the surgical procedure mostly used in fracture reduction of the tibial and femoral shafts. Following successful insertion of the nail into the medullary canal, it must be fixed by inserting screws through its proximal and distal locking holes. Prior to distal locking of the nail, surgeons must position the C-arm device and patient leg in such a way that the nail holes appear as circles in the X-ray image. This is considered a 'trial and error' process, is time consuming and requires many X-ray shots. We propose an augmented reality application that visually depicts to the surgeon two 'augmented' circles, their centers lying on the axis of the nail hole, making it visible in space. After an initial X-ray image acquisition, real-time video guidance allows the surgeon to superimpose the 'augmented' circles by moving the patient leg; the result being nail holes appearing as circles. Our nail pose recovery was evaluated on 1000 random trials and we consistently recovered the nail angulation within 2.76 ± 1.66°. Lastly, in a preclinical experiment involving 7 clinicians, we demonstrated that in over 95% of the trials, the nail hole appeared as a circle using an initial X-ray image.

Original languageEnglish
Title of host publicationInformation Processing in Computer-Assisted Interventions - 5th International Conference, IPCAI 2014, Proceedings
PublisherSpringer Verlag
Pages100-107
Number of pages8
ISBN (Print)9783319075204
DOIs
StatePublished - 2014
Event5th International Conference on Information Processing in Computer-Assisted Interventions, IPCAI 2014 - Fukuoka, Japan
Duration: 28 Jun 201428 Jun 2014

Publication series

NameLecture Notes in Computer Science (including subseries Lecture Notes in Artificial Intelligence and Lecture Notes in Bioinformatics)
Volume8498 LNCS
ISSN (Print)0302-9743
ISSN (Electronic)1611-3349

Conference

Conference5th International Conference on Information Processing in Computer-Assisted Interventions, IPCAI 2014
Country/TerritoryJapan
CityFukuoka
Period28/06/1428/06/14

Keywords

  • down-the-beam positioning
  • freehand distal locking
  • interlocking of intramedullary nailing
  • medical augmented reality
  • orthopedic and trauma surgery
  • visualization

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