Hands-on practice and implementations on a sound-guided 3D navigation system for orthopedic surgical applications

Computer assisted surgical navigation becomes crucial as the demand for accuracy and minimal invasiveness increases. During the treatment of tibial fracture with interlocking nail, the most uncomfortable procedure for an orthopedic surgeon is to find the location for distal locking screws. In this study, hands-on practice and implementation of a sound-guided 3D navigation system was discussed for the fixation of distal locking screws in the tibial intramedullary nailing. This system consists of a 3D digitizer arm, 3D coordinate registration/ transformation module and sound-guided navigation module. In addition, the proposed sound-guided navigation module was designed with an audio guiding mechanism through which a sound with different tones and intermittence frequencies will be produced for surgical manipulation. In vitro assessment was performed with a donor bone successfully, and a clinical case of a young male with tibial fracture was also carried out at the operation theater with satisfied results. No preoperative computed tomography or intraoperative fluoroscopy was required.