CN107595406B - Electromagnetic guiding system for fracture closed reduction treatment - Google Patents
Electromagnetic guiding system for fracture closed reduction treatment Download PDFInfo
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- CN107595406B CN107595406B CN201710829429.5A CN201710829429A CN107595406B CN 107595406 B CN107595406 B CN 107595406B CN 201710829429 A CN201710829429 A CN 201710829429A CN 107595406 B CN107595406 B CN 107595406B
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Abstract
The invention discloses an electromagnetic guiding system for closed reduction treatment of fracture, which is characterized by being provided with a magnetic field generator, an electromagnetic sensor, a CT scanner, a navigation control system and a power supply, wherein the electromagnetic sensor is electromagnetically connected with the magnetic field generator, the magnetic field generator and the CT scanner are respectively connected with the navigation control system, and the magnetic field generator, the CT scanner and the navigation control system are respectively connected with the power supply.
Description
Technical Field
The invention relates to the technical field of medical equipment, in particular to an electromagnetic guide system for closed reduction treatment of fracture.
Background
It is well known that orthopedic surgeons typically use open reduction internal fixation for fracture surgery. The clinical efficacy of this surgery is definite, but its substantial disadvantages are: the fracture incision reduction needs to expose more soft tissues, the wound is large, the postoperative pain time is long, and the fracture end has poor blood supply and long healing time due to great damage to the surrounding soft tissues; in the traditional Chinese medical science manual reduction, a doctor usually reduces the fracture by depending on experience, the doctor and a patient need to receive X-ray radiation injury for a long time in the reduction process, the labor intensity of an operator is high, and the fracture reduction effect excessively depends on the X-ray and the experience of the operator.
In order to solve the technical problems, the Chinese patent office discloses an invention patent application with a patent application number of 2017103328115 and a patent name of an individualized femoral fracture reduction model construction method, the scheme is to perform an operation under the action of X-ray fluoroscopy or multiple radiography, and the substantial defects are as follows: excessive application of X-ray radiation during surgery greatly increases radiation damage to the patient and the physician.
Disclosure of Invention
The invention aims to solve the defects of the prior art and provide the electromagnetic tracking visual reduction system for the fracture operation, which has the advantages of small surgical wound, small pain of a patient, small surgical reduction error, short postoperative recovery time, short surgical time and low labor intensity.
An electromagnetic guide system for closed reduction treatment of fracture is characterized by comprising a magnetic field generator, an electromagnetic sensor, a CT scanner, a navigation control system and a power supply, wherein the electromagnetic sensor is electromagnetically connected with the magnetic field generator, the magnetic field generator and the CT scanner are respectively connected with the navigation control system, the magnetic field generator, the CT scanner and the navigation control system are respectively connected with the power supply, when the electromagnetic tracking reduction is carried out in the operation, the CT scanner is used for carrying out CT scanning on the fracture part, CT scanning data are led into the navigation control system, then the magnetic field generator is started, the posture change of the space position information of a target magnetic field generator is tracked in real time, the position and the direction of the electromagnetic sensor of the fracture part are determined, the information is uploaded to the navigation control system, and meanwhile, the characteristic regions are selected in the navigation control system, and then carrying out point cloud registration: processing the point cloud registration data in a navigation control system, performing three-dimensional reconstruction in the navigation control system, importing coordinate values, registering the acquired information points with a CT model in real time, performing manual correction after registration, checking the overlapping degree of the registration points and a planning registration area, completing preoperative registration, and performing manual closing reset. Solves the substantive deficiency of the existing downward thighbone reduction by adopting X-ray fluoroscopy, and avoids the radiation injury of patients and doctors.
The foreground of the navigation control system of the invention develops a user interface based on QT, which is convenient for users to interact, the background uses VTK to realize three-dimensional computer graphics, image processing and visualization, the intraoperative registration model of the navigation control system is established by adopting the square sum of the minimized Euclidean distance between corresponding points of point cloud registration,
namely:
total NpCorresponding to the point.
The attitude change of the spatial position information of the magnetic field generator mainly adopts quaternion to describe the pose of a rigid body so as to achieve the purposes of simple attitude matrix method and no singular point effect, and when an attitude matrix is needed, the quaternion q0+ iq1+ jq2+ kq3 is converted into the following rotation matrix:
the calculation is greatly simplified.
By adopting the structure, the invention has the advantages of small operation wound, no radiation in the operation, short operation time, accurate fracture reduction, low labor intensity of operators, less pain of patients, short postoperative recovery time and the like.
Drawings
Fig. 1 is a schematic structural view of the present invention.
FIG. 2 is a QT development user interface diagram of the navigation control system of the present invention (three-dimensional images of fractured ends are automatically adjusted to standard sagittal, coronal, and axial positions).
FIG. 3 is a diagram of the reduction fracture effect of the navigation control system of the present invention.
FIG. 4 is a diagram of an electromagnetic navigation tracking embodiment of the present invention.
Reference numerals: a magnetic field generator 1, an electromagnetic sensor 2, a CT scanner 3, a navigation control system 4 and a power supply 5.
Detailed Description
The invention is further described below with reference to the accompanying drawings:
as shown in the attached drawings, the electromagnetic guiding system for the closed reduction treatment of the fracture is characterized by being provided with a magnetic field generator 1, an electromagnetic sensor 2, a CT scanner 3, a navigation control system 4 and a power supply 5, wherein the electromagnetic sensor 2 is electromagnetically connected with the magnetic field generator 1, the magnetic field generator 1 and the CT scanner 3 are respectively connected with the navigation control system 4, the magnetic field generator 1, the CT scanner 3 and the navigation control system 4 are respectively connected with the power supply, when the electromagnetic tracking reduction is carried out in the operation, the CT scanner 3 carries out CT scanning on the fracture part, CT scanning data is led into the navigation control system 4, then the magnetic field generator 1 is started, the posture change of the space position information of the target magnetic field generator 1 is tracked in real time through the navigation control system, the position and the direction of the electromagnetic sensor 2 at the fracture part are determined, and the information is uploaded to the navigation control system 4, these feature areas are simultaneously selected in the navigation control system 4 and then point cloud registration is performed: processing the point cloud registration data in a navigation control system, performing three-dimensional reconstruction in the navigation control system, importing coordinate values, registering the acquired information points with a CT model in real time, performing manual correction after registration, checking the overlapping degree of the registration points and a planning registration area, completing preoperative registration, and performing manual closing reset. Solves the substantive deficiency of the existing X-ray irradiation downlink fracture reduction, and avoids the radiation injury of patients and doctors.
The foreground of the navigation control system 4 of the invention develops a user interface based on QT, which is convenient for users to interact, the background uses VTK to realize three-dimensional computer graphics, image processing and visualization, the intraoperative registration model of the navigation control system is established by adopting the square sum of the minimized Euclidean distance between corresponding points of point cloud registration,
namely:
total NpCorresponding to the point.
Three axes (X, Y, Z) of the magnetic field generator 1 are taken as a reference coordinate system, the space position information of a tracking target relative to the magnetic field generator 1 can be described by the relative distance R, the azimuth angle alpha and the elevation angle beta of the tracking target, and the space posture of the tracking target relative to the magnetic field generator 1The information can be described by a roll angle phi, a yaw angle phi and a pitch angle theta, namely six degrees of freedom of a tracking target, the posture change of the spatial position information of the magnetic field generator 1 mainly adopts a quaternion to describe the posture of a rigid body so as to achieve the purposes of simplicity of a posture matrix method and no singular point, and when the posture matrix is needed, the quaternion q0+ iq1+ jq2+ kq3 is converted into the following rotation matrix:
the calculation is greatly simplified.
The navigation control system is composed of a navigation display and a PLC control unit, and the information uploaded by the CT scanner is received by the PLC control unit and is displayed in the navigation display after being processed in the PLC control unit.
Example (b): the invention takes the fracture of the middle section of the femoral shaft as an example, the total length of the femur is 40-60cm, and 5 marking points are respectively arranged at the bone ends at the two sides of the fracture end, and the marking points are the electromagnetic sensors.
Firstly, preoperative preparation: preparing 5 marked characteristic points and fixed reference frames (Marker) for fixing bone ends on two sides of the fractured end of the femur;
the method comprises the following specific steps:
1. fixed reference frame (Marker): a reference frame (Marker) for marking characteristic points outside a body is rigidly fixed on a bone on the affected side by applying a non-magnetic steel needle to the far end and the near end of the fracture respectively under local anesthesia, and an electromagnetic sensor is fixed on the reference frame (Marker) outside the body;
2. scanning CT: the CT scanner performs femoral CT scanning, and uploads CT scanning data to the navigation control system, wherein the scanning range of the CT scanner needs to cover the femoral bone on the affected side and the external marked characteristic points;
3. three-dimensional reconstruction: carrying out three-dimensional reconstruction on the imported CT data;
4. image segmentation: and separating the affected side bone and the characteristic points marked in vitro from the three-dimensional image of the navigation control system.
Secondly, point cloud registration: lying a patient on the operating bed, placing an Aurora plate (i.e. a magnetic field generator) on the operating bed, so that the femur on the affected side is within the spatial range of the Aurora plate (the magnetic field generator), which is usually 1000mm by 1000mm, sterilizing and spreading a towel conventionally,
thirdly, intraoperative registration: using a marking probe to collect in-vitro marked feature points in the regions marked with the feature points in vitro, selecting the feature regions in a navigation control system, and then carrying out point cloud registration: processing the point cloud data in a navigation control system, performing three-dimensional reconstruction in the navigation control system, importing coordinate values to enable the acquired information points to be registered with a CT model in real time, performing manual correction after registration, checking the overlapping degree of the registration points and a planning registration area, and completing preoperative registration and registration, wherein the error after registration needs to be controlled within 2 mm.
Fourthly, reduction of manipulations:
the three-dimensional image of the broken end of the fracture is automatically adjusted to be the standard sagittal position, coronal position and axial position (as shown in figure 2), the fracture is reduced, and the satisfactory effect of fracture reduction can be clearly seen on a large screen (as shown in figure 3).
The movement of a positioning surgical instrument (such as a probe with an electromagnetic sensor) relative to an affected side bone can be displayed through real-time navigation, the relative movement and the position relation of two bones in a fracture area can be displayed, after the reduction is completed, plaster can be fixed outside, such as unstable fracture, after the fracture reduction, an opening is formed in the front inner side of a femoral greater tuberosity fixed point, a nonmagnetic metal intramedullary needle with the electromagnetic sensor is placed under the guide of a magnetic navigation device, the intramedullary metal needle can be seen to enter the distal end of the femur through the fracture broken end through the navigation display, the intramedullary nail system with proper length and thickness is placed, a distal end locking nail and a proximal end locking nail are accurately locked under the electromagnetic navigation positioning, the fracture reduction error is 2mm, the rotation angle is controlled within 3 degrees, and the accuracy of the distal end locking nail and the proximal end locking nail is more than 95%.
By adopting the structure, the invention solves the substantial deficiency of descending fracture reduction by adopting X-ray irradiation at present, avoids the radiation injury of patients and doctors, and has the advantages of small operation wound, no radiation in the operation, short operation time, accurate fracture reduction, low labor intensity of operators, less pain of patients, short postoperative recovery time and the like.
Claims (1)
1. An electromagnetic guiding system for closed reduction treatment of fracture is characterized by being provided with a magnetic field generator, an electromagnetic sensor, a CT scanner, a navigation control system and a power supply, wherein the electromagnetic sensor is electromagnetically connected with the magnetic field generator, the magnetic field generator and the CT scanner are respectively connected with the navigation control system, the magnetic field generator, the CT scanner and the navigation control system are respectively connected with the power supply, the posture change of the spatial position information of the magnetic field generator mainly adopts quaternion to describe the posture of a rigid body, when a posture matrix is needed, the quaternion q0+ iq1+ jq2+ kq3 is converted into a rotary matrix,
the intraoperative registration model of the navigation control system is established by adopting the sum of squares of minimized Euclidean distances between corresponding points of point cloud registration, namely:
the navigation control system is composed of a navigation display and a PLC control unit, receives information uploaded by the CT scanner through the PLC control unit, processes the information in the PLC control unit and displays the information in the navigation display;
the use method of the electromagnetic guide system for fracture closed reduction treatment comprises the following steps:
firstly, preoperative preparation: preparing 5 marked characteristic points and a fixed reference frame for fixing bone ends on two sides of a fractured end of the femur;
the method comprises the following specific steps:
1) a fixed reference frame: respectively applying a non-magnetic steel needle to the far end and the near end of the fracture under local anesthesia to rigidly fix the reference frame for marking characteristic points outside the body on the affected side skeleton, and fixing the electromagnetic sensor on the reference frame outside the body;
2) scanning CT: the CT scanner performs femoral CT scanning, and uploads CT scanning data to the navigation control system, wherein the scanning range of the CT scanner needs to cover the femoral bone on the affected side and the external marked characteristic points;
3) three-dimensional reconstruction: the imported CT scanning data are sent to a navigation control system for three-dimensional reconstruction, and a three-dimensional image is obtained;
4) image segmentation: separating marked feature points marked outside the affected side bone and the body from the three-dimensional image of the navigation control system, and selecting a feature region containing the marked feature points in the navigation control system;
secondly, point cloud registration:
1) lying the patient on the operating bed, placing the magnetic field generator on the operating table to make the femur of the affected side in the space range of the magnetic field generator,
2) intraoperative point cloud registration: using a marking probe to mark the marked characteristic points in the area in vitro to collect the marked characteristic points in vitro, and then carrying out point cloud registration: processing the point cloud data in a navigation control system, performing three-dimensional reconstruction in the navigation control system, introducing coordinate values, registering the collected marking feature points and the three-dimensional image in real time, performing manual correction after registration, checking the overlapping degree of the registered collected marking feature points and the feature areas, and completing preoperative registration, wherein the error after registration needs to be controlled within 2 mm;
thirdly, reduction of manipulations: the three-dimensional image of the fracture end is automatically adjusted to be standard sagittal position, coronal position and axial position, and the fracture is reduced.
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| CN109820590B (en) * | 2019-02-15 | 2024-04-12 | 中国人民解放军总医院 | Pelvis fracture resets intelligent monitoring system |
| CN109984843B (en) * | 2019-03-20 | 2021-08-06 | 中国科学院苏州生物医学工程技术研究所 | Fracture closed reduction navigation system and method |
| CN110101452A (en) * | 2019-05-10 | 2019-08-09 | 山东威高医疗科技有限公司 | A kind of optomagnetic integrated positioning navigation method for surgical operation |
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| Publication number | Priority date | Publication date | Assignee | Title |
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| CN2587369Y (en) * | 2002-08-15 | 2003-11-26 | 刘道平 | Electromagnetic operation navigation apparatus based on C type X-ray unit |
| CN1931097A (en) * | 2006-09-30 | 2007-03-21 | 南方医科大学 | Human body orthopedic navigation system |
| CN101862205A (en) * | 2010-05-25 | 2010-10-20 | 中国人民解放军第四军医大学 | Intraoperative tissue tracking method combined with preoperative image |
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| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN2587369Y (en) * | 2002-08-15 | 2003-11-26 | 刘道平 | Electromagnetic operation navigation apparatus based on C type X-ray unit |
| CN1931097A (en) * | 2006-09-30 | 2007-03-21 | 南方医科大学 | Human body orthopedic navigation system |
| CN101862205A (en) * | 2010-05-25 | 2010-10-20 | 中国人民解放军第四军医大学 | Intraoperative tissue tracking method combined with preoperative image |
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Effective date of registration: 20220627 Address after: 264200 Shenyang road-96, gaoqu District, Weihai City, Shandong Province Patentee after: Weihai gaoqu Limin hospital Co.,Ltd. Patentee after: Cluster wave Patentee after: Hou Hongjun Address before: 264400 room 503, unit 2, No. 8, Beigong street, Wendeng City, Weihai City, Shandong Province Patentee before: Cluster wave Patentee before: Houhongjun |