A novel smart navigation system for intramedullary nailing in orthopedic surgery.

Abstract

This paper proposes a novel smart surgical navigation system for intramedullary nailing in orthopedic surgery. Using a handle-integrated laser guidance module, the system can target a drill insertion point onto skin, indicating an accurate target position to perpendicularly access an invisible distal hole. The proposed handle-integration-based fixation of the laser guidance module precisely defines the relative position of the module with respect to the distal hole. Consequently, unlike conventional systems, the proposed system can indicate the target insertion point without any help from bulky and costly external position-tracking equipment that is usually required for compensating disturbances generated by external impacts. After insertion, a correct drilling direction toward the distal hole is guided by real-time drilling angle measurement modules-one integrated with the nail handle and the other with the drill body. Each module contains a 9-axis inertial sensor and a Bluetooth communication device. These two modules work together to provide real-time drilling angle data, allowing calculation of the directional error toward the center of the distal hole in real time. The proposed system removes the need for fluoroscopy and provides a compact and cost-effective solution compared with conventional systems.