Three-dimensional augmented reality surgical navigation with hybrid optical and electromagnetic tracking for distal intramedullary nail interlocking.

BACKGROUND

Intramedullary nail (IMN) fixation improves functional outcomes for the diaphyseal fractures of long bones. However, locking the distal holes of the IMN is challenging. Although several navigation methods have been proposed, an intuitive, radiation-free and accurate navigation method that does not suffer from problems of hand-eye coordination has not yet been described.

METHODS

This paper proposes an augmented reality (AR) surgical navigation method with hybrid optical and electromagnetic (EM) tracking for distal IMN interlocking. Model experiments are designed to evaluate the AR-guided distal interlocking method.

RESULTS

AR-guided drilling procedures were performed on 5 tibia models and a leg phantom. The accuracy (hit or miss) was evaluated using fluoroscopy. The experimental results demonstrated that all 18 drills successfully hit the distal holes at a rate of 100%.

CONCLUSIONS

Our results indicate that the AR-guided distal interlocking method is feasible and has many potential applications in clinic after further evaluation.