I-Corps: Imaging Software for Long-Bone Fracture Alignment

该I-Corps项目更广泛的影响/商业潜力是为治疗股骨骨折的外科医生开发软件驱动的视觉辅助工具，以改善对线并防止再次手术。 在美国，每年发生大约350，000例股骨近端骨折和65，000例股骨干骨折。由于人口老龄化，骨折的数量正在增加，预计到2050年将翻一番。目前的外科手术是手动的，外科医生在对齐股骨骨折时会遇到无数并发症，包括难以实现准确复位、随后骨碎片对齐不良、高X射线辐射、骨不连并发症和软组织损伤。对线不良是长骨骨折的严重并发症，28%的患者在股骨骨折固定后发生15°或以上的对线不良。使用所提出的成像软件，外科医生可以具有更准确的视野并且能够在手术期间跟踪骨碎片的位置。跟踪系统可以防止尝试和错误的方法进行骨折对齐，并减少手术时间。通过使用所提出的成像软件，外科医生可以在术中检查对线骨的长度和旋转，这可能会防止对线不良和随后的再次手术。I-Corps项目是基于成像软件的开发，以帮助长骨骨折手术改善对线和防止再次手术。 使用所提出的成像软件，外科医生可以精确地感觉到骨段在空间中相对于彼此的位置。光学跟踪器用于找到连接到远端和近端骨碎片的2根棒的位置。然后在X射线图像上执行图像配准以找到骨段的精确三维（3D）位置。此外，未断骨的计算机断层扫描数据用于提供对齐骨折骨的数据。 使用所提出的成像软件，外科医生可以实时跟踪骨位置，同时将骨操纵到由健康骨的图像引导的最终期望位置。与目前用于检查骨位置和对线的二维X射线图像相比，这种3D视觉可能为外科医生提供优势。该奖项反映了NSF的法定使命，并通过使用基金会的智力价值和更广泛的影响审查标准进行评估，被认为值得支持。

The broader impact/commercial potential of this I-Corps project is the development of a software-driven visual aid for surgeons treating femur fractures to improve alignment and prevent reoperations. Approximately 350,000 proximal femur fractures and 65,000 femur shaft fractures occur in the United States annually. Due to the aging population, this number of fractures is increasing and is anticipated to double by the year 2050. Current surgical procedures are manual, and surgeons experience a myriad of complications to align femur fractures, including difficulty in achieving accurate reduction, subsequent malalignment of bone fragments, high x-ray radiation, nonunion complications, and soft tissue damage. Malalignment is a serious complication with long-bone fractures, with a malalignment of 15° or more after femur fracture fixation occurring in 28% of patients. Using the proposed imaging software, the surgeon may have more accurate vision and be able to track the position of the bone fragments during the surgery. The tracking system may prevent the trial-and-error approach for fracture alignment and reduce the time of the surgery. By using the proposed imaging software, the surgeon may check the length and rotation of the aligned bone intraoperatively, which may prevent malalignment and subsequent reoperations.This I-Corps project is based on the development of an imaging software to aid long-bone fracture surgery to improve alignment and prevent reoperations. Using the proposed imaging software, surgeons may have a precise sense of the bone segments' positions in space relative to each other. Optical trackers are used to find the position of 2 rods that are attached to the distal and proximal bone fragments. Image registration is then performed on the X-ray images to find the exact three dimensional (3D) position of the bone segments. In addition, computer tomography data of the unbroken bone is used to providing data to align the fractured bone. Using the proposed imaging software, the surgeon may track the bone position in real-time while manipulating the bone into the final desired position guided by the image of the healthy bone. This 3D vision may provide an advantage for surgeons in comparison to the 2D X-ray images that are used today to check the bone position and alignment.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.