Fractured Bone Alignment via 3D Virtual Model Overlay
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Solution Overview
Problem
Current methods for treating dislocated fractures of long bones, particularly in the lower extremities, face challenges such as angular and rotational malalignment of fracture fragments due to limited visualization capabilities during intraoperative procedures, which can lead to complications like false posture and joint strain.
Innovation Solution
A method involving the creation of 3D representations of contralateral and fractured bones, with landmarks extracted and transferred onto mirrored images to determine the relative position and orientation of bone fragments, allowing for improved alignment and reduction of malalignment during surgical procedures.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Object-affected harmful factors
If closed reduction internal fixation (CRIF) is used, then soft tissue preservation and reduced blood loss are achieved, but malalignment of fracture fragments occurs due to limited visualization
Solution Approach 1:
The patent creates virtual 3D copies of bone fragments from preoperative CT scans and overlays them onto intraoperative fluoroscopic images. This allows the surgeon to see the complete 3D structure and alignment of fracture fragments without exposing the fracture site directly, thereby maintaining the soft tissue benefits of CRIF while achieving precise alignment through virtual visualization guidance.
Solution Approach 2:
The patent transitions from 2D fluoroscopic images to 3D virtual bone models by integrating preoperative CT data with intraoperative X-ray images. This dimensional enhancement provides comprehensive spatial information about fracture fragment positions and orientations, enabling precise alignment control while maintaining closed reduction techniques.
2Loss of information
If intraoperative fluoroscopy is used for visualization, then real-time feedback is provided, but radiation exposure to patient and medical staff increases
Solution Approach 1:
The patent performs comprehensive 3D imaging and virtual model creation preoperatively using CT scans. These virtual models are then reused and overlaid onto intraoperative fluoroscopic images, reducing the need for extensive intraoperative fluoroscopy. This preliminary preparation provides real-time alignment feedback while minimizing radiation exposure by limiting the number and duration of intraoperative X-ray exposures.
3Measurement precision
If the entire bone including epiphyses is visualized, then rotational alignment and bone length can be determined, but the fluoroscope visualization capability is exceeded
Solution Approach 1:
The patent reconstructs complete 3D models of the entire bone including epiphyses from preoperative CT scans and overlays them onto 2D fluoroscopic images. This allows measurement of rotational alignment and bone length using the full 3D anatomical information while the fluoroscope continues to display only the limited 2D field of view, effectively bypassing the fluoroscope's area limitation through virtual 3D visualization.
Data Source
AI summary
A method and system for intraoperative, image-based reduction control for long bone shaft fracture treatment. The method includes preoperative steps of a) implanting markers into the proximal fragment and into the distal fragment of the broken bone, b) creating a 3D reference model of bone by taking a CT scan of the healthy bone, a CT scan of the broken bone and c) defining landmarks in the reference model based on the marker positions. The method further includes intraoperative steps of d) extracting the 3D position of the same landmarks from a series of 2D fluoroscopic images, using a reference object and e) comparing the positions the preoperatively defined landmarks and the positions of the intraoperatively extracted landmarks to calculate the malalignment of the fracture fragments.