On the design and experiments of a fluoro-robotic navigation system for closed intramedullary nailing of femur

Closed Intramedullary Nailing of Femur is a frequent orthopedic surgical operation. Traditionally, surgeons are performing the procedure based realtime on fluoroscopic images. Therefore, a great amount of X-Ray is exposed to both patient and surgeon. One of the most difficult tasks is the distal locking process which requires trail-and-error and skill for understanding 2D images generated from 3D objects. This paper describes the overall design and experimental sections of our research series on developing a surgical navigation system using a robot guiding device based on fluoroscopic images. Two approaches with and without employing optical tracking to generate relationship among tools, patient, and imaging system are presented. Moreover, a new technique to interface between surgeon and system is proposed to reduce the problem of hand-eye coordination on most surgical navigation system. This work is built on our previous work on path generation for distal locking process. Our experiment results show a promising solution for guiding the surgeon during the distal locking process in Closed Intramedullary Nailing of Femur.