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

I-Corps项目更广泛的影响/商业潜力是开发一种软件驱动的视觉辅助设备，用于外科医生治疗股骨骨折，以改善对齐并防止再次手术。在美国，每年大约发生35万例股骨近端骨折和6.5万例股骨骨干骨折。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工操作的，外科医生在调整股骨骨折时遇到了无数的并发症，包括难以实现准确复位、随后的骨碎片不对齐、高x射线辐射、不愈合并发症和软组织损伤。错位是长骨骨折的严重并发症，28%的患者在股骨骨折固定后出现15°或以上的错位。使用所提出的成像软件，外科医生可能有更准确的视觉，并能够在手术过程中跟踪骨碎片的位置。跟踪系统可以防止尝试和错误的方法进行骨折对准，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齐骨的长度和旋转，这可以防止对齐错误和随后的再手术。这个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齐和防止再手术。使用该成像软件，外科医生可以精确地感知骨段在空间中的相对位置。使用光学跟踪器找到附着在远端和近端骨碎片上的2根棒的位置。然后对x射线图像进行图像配准，以找到骨段的确切三维（3D）位置。此外，未骨折骨的计算机断层扫描数据用于提供骨折骨对齐的数据。使用所提出的成像软件，外科医生可以实时跟踪骨骼位置，同时在健康骨骼图像的引导下操纵骨骼进入最终所需的位置。与目前用于检查骨骼位置和排列的2D x射线图像相比，这种3D视觉可能为外科医生提供了优势。该奖项反映了美国国家科学基金会的法定使命，并通过使用基金会的知识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.