Single X-Ray 3D Guidance for Distal Locking of Intramedullary Nails
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Solution Overview
Problem
Existing surgical procedures for implanting bone stabilization devices, such as intramedullary nails, face challenges in distal locking due to nail bending and torsion, requiring multiple X-ray images and complex adjustments, especially when using long nails, and often necessitate the use of reference bodies that complicate the workflow and increase costs.
Innovation Solution
A method utilizing artificial intelligence, specifically deep learning and neural networks, to determine 3D representations and orientations of objects in X-ray images without the need for reference bodies, by analyzing image characteristics and object geometry, allowing for precise localization and adjustment of the X-ray imaging device based on typical operating room configurations.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If multiple X-ray images are acquired to enable correct implant placement and distal locking, then measurement precision and reliability are improved, but loss of time and productivity deteriorate
Solution Approach 1:
The system performs preliminary 3D reconstruction and virtual planning before the actual implantation. The long aiming device is pre-positioned and its 3D coordinates are determined in advance, allowing the surgeon to plan the exact drill hole trajectory and locking screw placement without needing multiple intraoperative X-ray images for adjustment
Solution Approach 2:
The system creates a virtual 3D copy of the patient's anatomy and implant configuration from a single X-ray image. This digital twin allows for virtual distal locking simulation and trajectory planning, replacing the need for multiple physical X-ray measurements during surgery
2Measurement precision
If reference bodies are used to determine C-arm position and imaging direction, then measurement precision is improved, but device complexity and cost increase
Solution Approach 1:
The long aiming device itself serves as the reference object for determining C-arm position and imaging direction. The device's known geometry and visible features in the X-ray image allow the system to automatically calculate the imaging direction and C-arm orientation without requiring separate reference bodies or markers
Solution Approach 2:
The long aiming device performs multiple functions: it guides the implant placement, serves as a reference for C-arm positioning, and enables 3D reconstruction. This multi-functionality eliminates the need for dedicated reference bodies that would otherwise be required for each function separately
3Device complexity
If free-hand distal locking is performed without mechanical guidance, then device complexity is reduced, but measurement precision and reliability deteriorate
Solution Approach 1:
The system replaces complex mechanical aiming devices with a software-based solution. The computer system calculates the precise drill hole trajectory and locking screw placement based on 3D reconstruction from a single X-ray image, substituting mechanical guidance with digital planning and navigation
Data Source
AI summary
Methods and systems are described which allow a classification of first and second objects in an X-ray projection image. A respective representation and localization of both objects are determined by applying the models to match the objects in the X-ray image and a spatial relation of the classified objects is obtained. Such methods and systems take advantage of artificial intelligence.