Non-radiative & Precise Navigation System for Distal Locking in Intramedullary Nailing

Abstract

Intramedullary nailing has been one of the most commonly used surgical procedure for treating long bone fracture in orthopedic surgeries. Intramedullary nailing consists of several procedures such as guide-wire insertion, reaming, nail insertion and distal locking. In particular, the distal locking has been known as one of the most challenging steps in this surgery. Because the nail is inserted and located in medullary canal so it is invisible to surgeon. For finding the position of nail and distal hole, in conventional method, surgeon uses large amount of radiography. In addition, while drilling and screw interlocking, since the nail is designed to have a longitudinal shape slightly bent by several millimeters so that it can conform to the bone canal shape, the exact position of the distal locking nail hole’s axes cannot be easily determined and the operating time becomes longer. This paper proposes a novel smart surgical navigation system for solving conventional limitations of intramedullary nailing. Using handle-integrated Laser guidance module, it can target the point onto the skin which indicates invisible distal nail hole. Owing to the characteristic of line-laser intersection, laser guidance module has a significant advantage of self-laser emitting toward distal nail hole without radiography. Additionally, through its fixation mechanism, the proposed laser guidance system does not need an additional tracking device for compensating disturbances from external impact. Not only to distal hole localization, for guiding the direction toward distal nail hole to surgeon while drilling, we proposed real-time drilling orientation measurement system. Handle and Drill integrated inertial sensors and Bluetooth communication module provide real-time angle data so that drill’s angle error toward center of distal nail hole is calculated in real-time. Our systems featured removing usage of fluoroscopic image and low-cost compared to conventional systems. ⓒ 2017 DGIST