A novel surgical navigation concept for Closed Intramedullary Nailing of femur using 4-DOF laser-guiding robot

Closed Intramedullary Nailing is a frequent orthopedic operation for fixing a long bone´s fractures. This technique requires the surgeon to insert an intramedullary nail into the bone canal of the fractured long bone, such as, femur, tibia and humorous. After the insertion, the surgeon is required to drill and interlock the bone with the nail by inserted two screws at the proximal and distal locking positions, called proximal and distal locking process. The difficulty is to locate and identify the position and orientation of the locking position which must be matched with the holes on the intramedullary nail. Traditionally, surgeon is working on locking process by using a large number of X-Ray images from fluoroscopic system for guiding with skill and trail-and-error process. This paper presents a new concept for surgical guiding using a 4-DOF laser-guiding robot to help navigating the surgeon to perform their work easier with higher accuracy. The proposed system consists of; (1) Image processing unit (IPU) which requires a few fluoroscopic images to process with our surgical path-generation algorithm, (2) 4-DOF laser-guiding robot which is our novel human-machine interaction approach, (3) Optical tracking system (OTS) used to identify position and orientation of the system´s component, and (4) Central control unit (CCU) which receives system components´ pose information from OTS, accepts surgical path from IPU, and, then, command the robot to guide the surgeon to perform surgery.