WO2023165158A1 - Dispositif de navigation médicale, dispositif et procédé de traitement de navigation, et système de navigation médicale - Google Patents

Dispositif de navigation médicale, dispositif et procédé de traitement de navigation, et système de navigation médicale Download PDF

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Publication number
WO2023165158A1
WO2023165158A1 PCT/CN2022/130944 CN2022130944W WO2023165158A1 WO 2023165158 A1 WO2023165158 A1 WO 2023165158A1 CN 2022130944 W CN2022130944 W CN 2022130944W WO 2023165158 A1 WO2023165158 A1 WO 2023165158A1
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Prior art keywords
position information
sensor
real
relative position
time
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PCT/CN2022/130944
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English (en)
Chinese (zh)
Inventor
郭楚
徐晓龙
何智圣
张柳云
陈德方
刘梦星
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武汉迈瑞科技有限公司
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Priority to CN202280007393.1A priority Critical patent/CN116887775A/zh
Publication of WO2023165158A1 publication Critical patent/WO2023165158A1/fr

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/30—Surgical robots
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
    • A61B6/12—Arrangements for detecting or locating foreign bodies
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
    • G06T19/00—Manipulating 3D models or images for computer graphics
    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
    • G06T7/00—Image analysis
    • G06T7/70—Determining position or orientation of objects or cameras
    • G06T7/73—Determining position or orientation of objects or cameras using feature-based methods
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H30/00—ICT specially adapted for the handling or processing of medical images
    • G16H30/20—ICT specially adapted for the handling or processing of medical images for handling medical images, e.g. DICOM, HL7 or PACS
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H30/00—ICT specially adapted for the handling or processing of medical images
    • G16H30/40—ICT specially adapted for the handling or processing of medical images for processing medical images, e.g. editing
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A61B2034/2068—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis using pointers, e.g. pointers having reference marks for determining coordinates of body points
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
    • A61B2090/392—Radioactive markers

Definitions

  • the present application relates to the field of medical technology, in particular to a medical navigation device, a navigation processing device, a navigation method for the medical navigation device, an electronic device, a computer-readable storage medium, a computer program product, and a medical navigation system.
  • orthopedic surgical tools or instruments In clinical orthopedic surgery, some operations require the insertion of orthopedic surgical tools or instruments. Take the occurrence of proximal femoral fractures (such as intertrochanteric fractures) or fractures of long bones such as the tibia or humerus as examples. Orthopedic surgery requires insertion of Intramedullary nailing, and treatment with intramedullary nailing to facilitate fracture healing. When inserting orthopedic surgical tools or instruments, the specific insertion positions and insertion directions of these orthopedic surgical tools or instruments will affect the later operation effect and the recovery effect after the operation.
  • the present application provides one or more of a medical navigation device, a navigation processing device, a navigation method for a medical navigation device, an electronic device, a computer-readable storage medium, a computer program product, or a medical navigation system.
  • the present application provides a medical navigation device for intramedullary nail insertion point navigation, including a processor, a sensor and a navigation prompt component;
  • the processor is configured to, in response to a trigger instruction, record the reference position information measured by the sensor when the sensor is at the reference position, and acquire the sensor's position when the sensor is fixed to the orthopedic surgical tool.
  • Real-time position information based on the real-time position information to obtain first relative position information and/or second relative position information;
  • the first relative position information is the relative position information between the real-time position of the sensor and the reference position , the real-time position is determined by the real-time position information;
  • the second relative position information is the relative position information between the real-time position and the ideal nail entry point of the intramedullary nail, and the second relative position information is determined by the Real-time position information and target offset position information are determined, and the target offset position information is used to indicate the relative positional relationship between the reference position and the ideal nail entry point of the intramedullary nail;
  • the navigation prompt component is used to prompt the first relative position information and/or the second relative position information
  • the first relative position information combined with the target offset position information, and/or, the second relative position information can be used to assist in guiding the orthopedic surgical tool to move to the ideal nail entry point of the intramedullary nail .
  • the present application provides a medical navigation device for guiding orthopedic surgical tools, including a processor, a sensor, and a navigation prompt component;
  • the processor is configured to, in response to a trigger instruction, record the reference position information measured by the sensor when the sensor is at the reference position, and acquire the sensor's position when the sensor is fixed to the orthopedic surgical tool.
  • Real-time position information based on the real-time position information to obtain first relative position information and/or second relative position information;
  • the first relative position information is the relative position information between the real-time position of the sensor and the reference position , the real-time position is determined by the real-time position information;
  • the second relative position information is the relative position information between the real-time position and the target position, and the second relative position information is determined by the real-time position information and the target determined by offset position information,
  • the target offset position information is used to indicate the relative positional relationship between the reference position and the target position, the target position is determined by the expected insertion position of the orthopedic surgical tool in the human body and / or intended insertion direction determination;
  • the navigation prompt component is used to prompt the first relative position information and/or the second relative position information
  • the first relative position information combined with the target offset position information, and/or, the second relative position information may be used to assist in guiding the orthopedic surgery tool to move to the target position.
  • the present application provides a medical navigation device for guiding orthopedic surgery tools, including a processor, a sensor, a communication component, and a navigation prompt component;
  • the processor is configured to send the real-time position information measured by the sensor to an external processing device through the communication component when the sensor is fixed to the orthopedic surgical tool, and receive the position information through the communication component.
  • the first relative position information is the relative position information between the real-time position of the sensor and the reference position where the sensor is located in advance,
  • the real-time position is determined by the real-time position information
  • the reference position is determined by pre-recorded reference position information
  • the reference position information includes first reference position information and/or second reference position information, the first reference position
  • the position information is the position information measured by the sensor obtained by the medical navigation device in response to the trigger instruction and sent to the external processing device, and the second reference position information is obtained by the external processing device in response to the trigger instruction
  • the second relative position information is the relative position information between the real-time position of the sensor and the target position
  • the second relative position information is determined by the real-time
  • the processor also transmits the first relative position information and/or the second relative position information to the navigation prompt component;
  • the navigation prompt component is used to prompt the first relative position information and/or the second relative position information
  • the first relative position information combined with the target offset position information, and/or, the second relative position information may be used to assist in guiding the orthopedic surgery tool to move to the target position.
  • the present application provides a medical navigation device for guiding orthopedic surgical tools, including a processor, a sensor, and a communication component;
  • the processor is configured to, in response to a trigger instruction, record the reference position information measured by the sensor when the sensor is at the reference position, and acquire the sensor's position when the sensor is fixed to the orthopedic surgical tool.
  • Real-time location information obtaining first relative location information and/or second relative location information based on the real-time location information, and transmitting the first relative location information and/or the second relative location information through the communication component
  • the external prompting device prompts the first relative position information and/or the second relative position information; wherein, the first relative position information is the real-time position of the sensor and the The relative position information between the reference positions, the real-time position is determined by the real-time position information; the second relative position information is the relative position information between the real-time position and the target position, and the second relative position
  • the information is determined by the real-time position information and target offset position information, the target offset position information is used to indicate the relative positional relationship between the reference position and the target position, and the target position is determined by the orthopedic surgery Determination of the intended insertion position
  • the first relative position information combined with the target offset position information, and/or, the second relative position information may be used to assist in guiding the orthopedic surgery tool to move to the target position.
  • the present application provides a navigation processing device for guiding an orthopedic surgical tool, the navigation processing device is communicatively connected with a medical navigation device, and the medical navigation device includes a processor, a sensor and a communication component;
  • the navigation processing device is configured to acquire the real-time position information measured by the sensor in the state where the sensor is fixed to the orthopedic surgical tool and sent by the processor through the communication component, based on the real-time position information Acquiring the first relative position information and/or the second relative position information, and prompting the first relative position information and/or the second relative position information;
  • the first relative position information is the real-time position and The relative position information between the reference positions where the sensor is located in advance, the real-time position is determined by the real-time position information, the reference position is determined by the pre-recorded reference position information, and the reference position information includes the first reference Position information and/or second reference position information,
  • the first reference position information is the position information measured by the sensor obtained by the medical navigation device in response to a trigger instruction and sent to the navigation processing device,
  • the second The second reference position information is the preset position information obtained by the navigation processing device in response to the trigger instruction;
  • the second relative position information is the relative position information between the real-time position and the target position, and the
  • the first relative position information combined with the target offset position information, and/or, the second relative position information may be used to assist in guiding the orthopedic surgery tool to move to the target position.
  • the present application provides a navigation method of a medical navigation device used for intramedullary nail insertion point navigation, the medical navigation device is provided with sensors, and the method includes:
  • the first relative position The information is relative position information between the real-time position of the sensor and the reference position, and the real-time position is determined by the real-time position information;
  • the second relative position information is the ideal distance between the real-time position and the intramedullary nail.
  • relative position information between nail points the second relative position information is determined by the real-time position information and target offset position information, and the target offset position information is used to indicate that the reference position is different from the intramedullary nail Relative positional relationship between ideal nail entry points;
  • the present application provides a navigation method for a medical navigation device for guiding an orthopedic surgical tool, the medical navigation device is provided with a sensor, and the method includes:
  • the first relative position The information is relative position information between the real-time position of the sensor and the reference position, and the real-time position is determined by the real-time position information;
  • the second relative position information is the relative position between the real-time position and the target position relative position information, the second relative position information is determined by the real-time position information and target offset position information, and the target offset position information is used to indicate the relative position relationship between the reference position and the target position , the target position is determined by the expected insertion position and/or expected insertion direction of the orthopedic surgical tool in the human body;
  • Prompting the first relative position information and/or the second relative position information in real time, wherein the first relative position information is combined with the target offset position information, and/or the second relative position information, Can be used to assist in guiding the movement of the orthopedic surgical tool to the target location.
  • the present application provides a navigation method for a medical navigation device used to guide an orthopedic surgical tool, the medical navigation device is provided with a sensor, and the method includes:
  • the first relative position information is the relative position between the real-time position of the sensor and the reference position where the sensor is in advance Position information, the real-time position is determined by the real-time position information, the reference position is determined by the pre-recorded reference position information, the reference position information is obtained by the medical navigation device in response to a trigger instruction and sent to the The position information measured by the sensor of the external processing device, and/or, the reference position information is preset position information obtained by the external processing device in response to a trigger instruction; the second relative position information is the sensor The relative position information between the real-time position and the target position, the second relative position information is determined by the real-time position information and the target offset position information, and the target offset position information is used to indicate the reference position and the target position The relative positional relationship between the target positions, the target position is determined by the expected insertion position and/or expected insertion direction of the orthopedic surgical tool in the human body;
  • Prompting the first relative position information and/or the second relative position information in real time, the first relative position information combined with the target offset position information, and/or the second relative position information can be used for Assisting in guiding movement of the orthopedic surgical tool to the target location.
  • the present application provides a navigation method for a medical navigation device used to guide an orthopedic surgical tool, the medical navigation device is provided with a sensor, and the method includes:
  • the first relative position The information is relative position information between the real-time position of the sensor and the reference position, and the real-time position is determined by the real-time position information;
  • the second relative position information is the relative position between the real-time position and the target position relative position information, the second relative position information is determined by the real-time position information and target offset position information, and the target offset position information is used to indicate the relative position relationship between the reference position and the target position , the target position is determined by the expected insertion position and/or expected insertion direction of the orthopedic surgical tool in the human body;
  • the external prompting device prompts the first relative position information and/or the second relative position information , the first relative position information combined with the target offset position information, and/or, the second relative position information may be used to assist in guiding the orthopedic surgery tool to move to the target position.
  • the present application provides a navigation method for a medical navigation device used to guide orthopedic surgical tools, the medical navigation device is provided with sensors, the medical navigation device communicates with a navigation processing device, and the method is implemented by the Executed by a navigation processing device, the method includes:
  • first relative position information and/or second relative position information based on the real-time position information, where the first relative position information is the relative position between the real-time position of the sensor and the reference position where the sensor is located in advance Information, the real-time position is determined by the real-time position information, the reference position is determined by the pre-recorded reference position information, the reference position information is obtained by the medical navigation device in response to a trigger instruction and sent to the navigation
  • the position information measured by the sensor of the processing device, and/or, the reference position information is preset position information obtained by the navigation processing device in response to a trigger instruction;
  • the second relative position information is the real-time position Relative position information between the target position, the second relative position information is determined by the real-time position information and target offset position information, and the target offset position information is used to indicate the reference position and the target position
  • the relative positional relationship between, the target position is determined by the expected insertion position and/or expected insertion direction of the orthopedic surgical tool in the human body;
  • Prompt the first relative position information and/or the second relative position information in real time; the first relative position information combined with the target offset position information, and/or, the second relative position information, can be used for Assisting in guiding movement of the orthopedic surgical tool to the target location.
  • the present application provides an electronic device, including a processor and a memory, the memory stores a computer program, wherein, when the computer program is executed by the processor, the processor implements the above The steps of the method in any of the described embodiments.
  • the present application provides a computer-readable storage medium, on which a computer program is stored, wherein, when the computer program is executed by the processor, the processor implements any one of the above-mentioned The steps of the methods in the examples.
  • the present application provides a computer program product, including a computer program, wherein, when the computer program is executed by a processor, the steps of the method in any one of the foregoing embodiments are implemented.
  • the present application provides a medical navigation system, which includes: an orthopedic surgical tool, and the device in any one of the above-mentioned embodiments.
  • the orthopedic surgical tool by prompting the first relative position information and/or the second relative position information, the orthopedic surgical tool can be assisted to move to the target position such as the ideal nail entry point of the intramedullary nail without causing
  • the radiation dose during the operation is increased, which is convenient and convenient, and is beneficial to assist in improving the efficiency of orthopedic surgery.
  • FIG. 1 is a schematic structural diagram of a medical navigation device according to some embodiments of the present application.
  • Fig. 2 is a schematic structural diagram of a medical navigation device combined with an external processing device in some embodiments of the present application;
  • Fig. 3 is a schematic structural diagram of a medical navigation device combined with an external prompt device according to some embodiments of the present application;
  • Fig. 4 is a schematic structural diagram of a medical navigation device combined with a navigation processing device in some embodiments of the present application;
  • Fig. 5 is a schematic diagram of a medical navigation device according to some embodiments of the present application.
  • FIG. 6 is an example of a coordinate system of a sensor in some embodiments of the present application.
  • Fig. 7 is a schematic diagram of the first relative position information and/or the second relative position information displayed by the medical navigation device in some embodiments of the present application;
  • Fig. 8 is a schematic diagram of the principle of determining the height difference in some embodiments of the present application.
  • Fig. 9 is a schematic diagram of the principle of determining the deflection angle in some embodiments of the present application.
  • Fig. 10 is a schematic diagram of the principle of determining the pitch angle in some embodiments of the present application.
  • Fig. 11 is the schematic diagram of the ideal nailing position of the ideal nailing point of the intramedullary nail at the proximal end of the femur;
  • Fig. 12 is a schematic diagram of the ideal nailing direction of the ideal nailing point of the intramedullary nail at the proximal end of the femur;
  • Fig. 13 is an example diagram of an application scenario in which a medical navigation device is placed on the body surface of the affected proximal femur to determine a reference position in some embodiments;
  • Fig. 14 is a schematic diagram of determining target offset position information based on medical images in some embodiments.
  • Fig. 15 is a schematic diagram of determining target offset position information based on medical images in other embodiments.
  • Fig. 16 is a schematic diagram of fixing the medical navigation device and the guide wire in one embodiment
  • Fig. 17 is a schematic diagram of fixing the medical navigation device and the electric drill in one embodiment
  • Fig. 18 is a schematic diagram of an ideal nail entry position for determining an ideal nail entry point of an intramedullary nail in an application scenario of some embodiments;
  • Fig. 19 is a schematic diagram of an ideal nail entry direction for determining an ideal entry point of an intramedullary nail in an application scenario of some embodiments;
  • Fig. 20 is a schematic flowchart of a medical navigation method in some embodiments.
  • Fig. 21 is a schematic flowchart of a medical navigation method in other embodiments.
  • Fig. 22 is a schematic flowchart of a medical navigation method in other embodiments.
  • Fig. 23 is a schematic flowchart of a medical navigation method in some other embodiments.
  • Fig. 24 is a schematic structural block diagram of an electronic device in some embodiments.
  • a medical navigation device 10 in some embodiments includes a processor 13 , a sensor 11 and a navigation prompt component 12 .
  • the medical navigation device 10 can be applied in orthopedic surgery to guide orthopedic surgical tools.
  • the processor 13 is configured to record the reference position information measured by the sensor 11 when the sensor 11 is in the reference position in response to the trigger instruction, and acquire the real-time position information of the sensor 11 in a state where the sensor 11 is fixed to the orthopedic surgical tool, based on
  • the real-time position information acquires the first relative position information and/or the second relative position information;
  • the first relative position information is the relative position information between the real-time position of the sensor 11 and the reference position, and the real-time position is determined by the real-time position information;
  • the position information is the relative position information between the real-time position and the target position, the second relative position information is determined by the real-time position information and the target offset position information, and the target offset position information is used to indicate the relative position between the reference position and the target position relationship, the target location is determined by the intended insertion location and/or intended insertion direction of the orthopedic surgical tool in the human body;
  • the navigation prompt component 12 is used to prompt the first relative position information and/or the second relative position information
  • the first relative position information combined with the target offset position information, and/or, the second relative position information can be used to assist in guiding the orthopedic surgery tool to move to the target position.
  • the medical navigation device 10 in some embodiments includes a processor 13 , a sensor 11 , a communication component 14 and a navigation prompt component 12 .
  • the medical navigation device 10 can be applied in orthopedic surgery to guide orthopedic surgical tools. When the medical navigation device 10 is applied in orthopedic surgery, it can guide orthopedic surgical tools by cooperating with the external processing device 20 .
  • the processor 13 is configured to send the real-time position information measured by the sensor 11 to the external processing device 20 through the communication component 14 when the sensor 11 is fixed to the orthopedic surgical tool, and receive feedback from the external processing device 20 through the communication component 14 First relative position information and/or second relative position information;
  • the first relative position information is the relative position information between the real-time position of sensor 11 and the reference position where sensor 11 is in advance, real-time position is determined by real-time position information, reference The position is determined by pre-recorded reference position information.
  • the reference position information includes first reference position information and/or second reference position information.
  • the first reference position information is obtained by the medical navigation device 10 in response to a trigger instruction and sent to the external processing device
  • the position information measured by the sensor 11 of 20 is the preset position information obtained by the external processing device 20 in response to the trigger instruction;
  • the second relative position information is the relative position between the real-time position of the sensor 11 and the target position information, the second relative position information is determined by real-time position information and target offset position information, the target offset position information is used to indicate the relative positional relationship between the reference position and the target position, and the target position is determined by the expected position of the orthopedic surgical tool in the human body Determination of insertion location and/or intended insertion direction;
  • the processor 13 also transmits the first relative position information and/or the second relative position information to the navigation prompt component 12;
  • the navigation prompt component 12 is used to prompt the first relative position information and/or the second relative position information
  • the first relative position information combined with the target offset position information, and/or, the second relative position information can be used to assist in guiding the orthopedic surgery tool to move to the target position.
  • the medical navigation device 10 in some embodiments includes a processor 13 , a sensor 11 and a communication component 14 .
  • the medical navigation device 10 can be applied in orthopedic surgery to guide orthopedic surgical tools.
  • it can guide orthopedic surgical tools by cooperating with the external prompting device 30 .
  • the processor 13 is configured to record the reference position information measured by the sensor 11 when the sensor 11 is in the reference position in response to the trigger instruction, and acquire the real-time position information of the sensor 11 in a state where the sensor 11 is fixed to the orthopedic surgical tool, based on The real-time position information acquires the first relative position information and/or the second relative position information, and transmits the first relative position information and/or the second relative position information to the external prompting device 30 through the communication component 14, and the external prompting device 30 will The first relative position information and/or the second relative position information prompt;
  • the first relative position information is the relative position information between the real-time position of the sensor 11 and the reference position, and the real-time position is determined by the real-time position information;
  • the position information is the relative position information between the real-time position and the target position, the second relative position information is determined by the real-time position information and the target offset position information, and the target offset position information is used to indicate the relative position between the reference position and the target position relationship, the target location is determined by the intended insertion
  • the first relative position information combined with the target offset position information, and/or, the second relative position information can be used to assist in guiding the orthopedic surgery tool to move to the target position.
  • the external prompting device 30 may be any device capable of information prompting.
  • the external prompting device 30 may be a smart wearable device.
  • the external prompting device can be a user terminal (such as a personal computer, a tablet computer), in some embodiments, the external prompting device can be a display screen device, in some embodiments, the external prompting device can also be Can be a voice output device.
  • the medical navigation device 10 in some embodiments includes a processor 13 , a sensor 11 and a communication component 14 .
  • the medical navigation device 10 can be applied in orthopedic surgery to guide orthopedic surgical tools.
  • it can guide orthopedic surgical tools by cooperating with the navigation processing device 40 .
  • the navigation processing device 40 is configured to acquire the real-time position information measured by the sensor 11 when the sensor 11 is fixed to the orthopedic surgical tool and sent by the processor 13 through the communication component 14, and acquire the first relative position information and the first relative position information based on the real-time position information.
  • the first relative position information is the relative position information between the real-time position of the sensor 11 and the reference position where the sensor 11 is in advance , the real-time position is determined by real-time position information, the reference position is determined by pre-recorded reference position information, the reference position information includes first reference position information and/or second reference position information, and the first reference position information is the medical navigation device 10 responding to The trigger command is obtained and sent to the position information measured by the sensor 11 of the navigation processing device 40.
  • the second reference position information is the preset position information obtained by the navigation processing device 40 in response to the trigger command;
  • the second relative position information is the real-time position and The relative position information between the target positions, the second relative position information is determined by the real-time position information and the target offset position information, the target offset position information is used to indicate the relative position relationship between the reference position and the target position, and the target position is determined by the Department of Orthopedics Determination of the intended insertion position and/or intended direction of insertion of the surgical tool in the human body;
  • the first relative position information combined with the target offset position information, and/or, the second relative position information can be used to assist in guiding the orthopedic surgery tool to move to the target position.
  • the sensor 11 can be an inertial sensor, and an inertial sensor is a type of sensor that can detect and measure acceleration, tilt, shock, vibration, rotation, and multi-degree-of-freedom motion.
  • the inertial sensor can Measure and output position information.
  • the number of the sensor 11 is specifically one, so that medical navigation can be realized based on the same sensor.
  • the medical navigation device 10 in each of the above-mentioned embodiments can be applied to orthopedic surgery requiring the insertion of an intramedullary nail, such as the orthopedic surgery process of a proximal femur fracture.
  • the above-mentioned medical navigation device 10 may be a medical navigation device used for navigation of intramedullary nail entry points
  • the above-mentioned target position may be an ideal nail entry point of an intramedullary nail
  • the above-mentioned expected insertion position may be an ideal nail entry position of an ideal intramedullary nail entry point
  • the above-mentioned The expected insertion direction may be an ideal nail entry direction of an ideal nail entry point for the intramedullary nail.
  • the medical navigation device 10 can be detachably fixed to the orthopedic surgical tool.
  • the medical navigation device 10 can be detachably fixed to the orthopedic surgical tool by means of magnetic attraction and/or clamping.
  • the orthopedic surgical tool can be a guide wire, a gripper or an electric drill.
  • a touch screen may be provided in the medical navigation device 10 involved in the above embodiments, so that the medical navigation device 10 may receive a trigger instruction through the touch screen, and the trigger instruction may be used to instruct to record the above reference Baseline location information for the location.
  • the medical navigation device 10 by operating the corresponding buttons or controls displayed on the touch screen, or clicking or double-clicking on a designated area or any position on the touch screen, or sliding a specified track on the touch screen, or through other touch methods, Issue a trigger command. If the medical navigation device 10 receives an operation action of operating a corresponding button or control through the touch screen, or recognizes a specified touch action, such as single click, double click, or a specified sliding track, etc., it determines that a trigger instruction is received.
  • a specified touch action such as single click, double click, or a specified sliding track, etc.
  • the medical navigation device 10 may also be provided with physical buttons and/or voice collection components, so as to receive trigger instructions through the physical buttons and/or voice collection components , the trigger instruction may be used to instruct to record the reference position information of the above reference position.
  • a trigger command can be issued by directly pressing the physical button.
  • the medical navigation device 10 receives a pressing operation through the physical key, it determines that a trigger instruction is received.
  • the medical navigation device 10 is provided with a voice collection component
  • the medical staff such as a doctor
  • the voice collection component collects voice information and recognizes the voice information. If it is recognized that the voice information includes "recording reference position", “recording position” or other predefined reference position information used to indicate the recording reference position, the medical navigation device 10 determines that a trigger instruction is received.
  • the medical navigation device 10 involved in the above-mentioned embodiments, it is also possible to set a touch screen, a physical button, and a voice collection component on the external processing device 20 and/or the external prompt device 30 and/or the navigation processing device 40 components that can receive a trigger instruction, so as to receive the trigger instruction through the external processing device 20 and/or the external prompt device 30 and/or the navigation processing device 40 .
  • the trigger instructions received by the external processing device 20 and/or the external prompting device 30 and/or the navigation processing device 40 may be forwarded to the medical navigation device 10 .
  • the way that the navigation prompting component 12 and/or the external prompting device 30 and/or the navigation processing device 40 prompts the first relative position information and/or the second relative position information can be that the first relative position information and/or the second relative position information
  • the real-time display of the information may also be to output the voice information of the first relative position information and/or the second relative position information, that is, give voice prompts to the voice information of the first relative position information and/or the second relative position information.
  • the manner of displaying the first relative position information and/or the second relative position information in real time is not limited, for example, only the first relative position information and/or the second relative position information may be displayed, or the first relative position information and/or the second relative position information may be displayed or the second relative position information, simultaneously display corresponding descriptive information, the descriptive information is used to explain the specific meaning of the displayed first relative position information and/or the second relative position information.
  • the information of the suggested moving direction based on the first relative position information and/or the second relative position information may also be displayed at the same time, where different moving directions may be marked with different marks, for example, different different colors and/or different arrow directions etc.
  • a voice prompt corresponding to the descriptive information is used to explain the first relative position information and/or the second relative position information of the voice prompt
  • the information of the suggested moving direction based on the first relative position information and/or the second relative position information may also be voiced at the same time.
  • the above-mentioned reference position information is the position information obtained by real-time measurement of the sensor 11 obtained in response to the trigger command when the trigger command is received.
  • the medical navigation device 10 can directly obtain the position information obtained by the real-time measurement of the sensor 11 .
  • the external processing device 20 and/or the external prompting device 30 and/or the navigation processing device 40 can use the trigger instruction Forward to the medical navigation device 10, or send an instruction to the medical navigation device 10 based on the trigger instruction to instruct the medical navigation device 10 to provide position information, so as to instruct the medical navigation device 10 to obtain the position information obtained by the real-time measurement of the sensor 11, and feed it back to the external processing
  • the device 20 and/or the external prompting device 30 and/or the navigation processing device 40 so that the external processing device 20 and/or the external prompting device 30 and/or the navigation processing device 40 obtains the reference position information, and the reference obtained in this way
  • the location information may be referred to as first reference location information in this embodiment of the present application.
  • the above-mentioned reference position information is the position information obtained by the sensor 11 after the sensor 11 is initialized in response to the trigger command when the trigger command is received, that is, the reference position information may be the initial position information of the sensor 11, the present application In the embodiment, it may be referred to as the second reference position information.
  • the initial position information may be set based on actual technical requirements.
  • the initial position information may be zero position information.
  • the zero position information may refer to that the values of position-related information are all set to 0, for example, the height value is 0.
  • the medical navigation device 10 may directly initialize the sensor 11 to obtain the position information measured and obtained after the sensor 11 is initialized.
  • the external processing device 20 and/or the external prompting device 30 and/or the navigation processing device 40 When the trigger instruction is received by the external processing device 20 and/or the external prompting device 30 and/or the navigation processing device 40, in some embodiments, the external processing device 20 and/or the external prompting device 30 and/or the navigation processing device 40 , the position information preset in the external processing device 20 and/or the external prompting device 30 and/or the navigation processing device 40 may be used as the reference position information, and the preset position information is the initial position information after the sensor 11 is initialized. At the same time, when the external processing device 20 and/or the external prompting device 30 and/or the navigation processing device 40 receive the trigger instruction, they can simultaneously forward the trigger instruction to the medical navigation device 10, or send the trigger instruction to the medical navigation device 10 based on the trigger instruction. The initialization instruction is used to instruct the medical navigation device 10 to initialize the sensor 11 .
  • the external processing device 20 and/or the external prompting device 30 and/or the navigation processing device 40 when the external processing device 20 and/or the external prompting device 30 and/or the navigation processing device 40 receives the trigger instruction, it may forward the trigger instruction to the medical navigation device 10, or send the medical navigation device 10 based on the trigger instruction.
  • the navigation device 10 sends an instruction to instruct the medical navigation device 10 to initialize the sensor 11 and provide the position information measured by the sensor 11 after the initialization of the sensor 11 .
  • the medical navigation device 10 initializes the sensor 11, obtains the position information measured by the sensor 11, and feeds it back to the external processing device 20 and/or the external prompting device 30 and/or the navigation processing device 40, so that the external processing The device 20 and/or the external prompting device 30 and/or the navigation processing device 40 obtain the reference position information.
  • the first relative position information includes a first displacement deviation and/or a first angular deviation between the real-time position and the reference position.
  • the first displacement deviation may include: the distance between the real-time position of the sensor 11 and the reference position in a direction perpendicular to the horizontal plane. Wherein, in some embodiments, the first displacement deviation may also be referred to as a height difference, as shown in FIG. 8 .
  • the first angular deviation may include: after projecting the designated direction of the sensor 11 fixed to the orthopedic surgical tool and the designated direction of the sensor 11 at the reference position onto the same plane, the difference between the two projections on the plane angle.
  • the first angular deviation may also be referred to as an outer deflection angle.
  • the specified direction of the sensor 11 may specifically be the axis direction of the medical navigation device 10, and the same plane may specifically be a horizontal plane, as shown in FIG. 9 .
  • the designated direction of the sensor 11 fixed to the orthopedic surgical tool and the designated direction of the sensor 11 at the reference position it can be projected in combination with the coordinate system established by the sensor 11 itself.
  • the coordinate system established by the sensor 11 itself is shown in FIG. 6 .
  • the X-axis of the coordinate system established by the sensor 11 itself is the axis direction of the medical navigation device 10 , that is, the specified direction of the sensor 11 .
  • the second relative position information includes a second displacement deviation and/or a second angular deviation between the real-time position and the target position, wherein the target position is determined by the expected insertion position and/or the expected insertion position of the orthopedic surgical tool in the human body.
  • the insertion direction is determined.
  • the target position may be the ideal insertion point of the intramedullary nail, etc., where the surgical tool is expected to be inserted.
  • the second relative position information includes the real-time position and the intramedullary The second displacement deviation and/or the second angle deviation between the ideal nail entry points.
  • the expected insertion position is the ideal nail entry position of the ideal nail entry point of the intramedullary nail
  • the expected insertion direction is the ideal nail entry position of the intramedullary nail.
  • the second angle deviation includes: after projecting the designated direction of the sensor 11 at the real-time position and the expected insertion direction of the target position, for example, the ideal nailing direction of the ideal nailing point of the intramedullary nail, all projected onto the same plane, the The angle between the two projections.
  • the designated direction of the sensor 11 may specifically be the axis direction of the medical navigation device 10, and the same plane may specifically be a horizontal plane.
  • the expected insertion direction for example, the ideal nail entry direction of the ideal nail entry point of the intramedullary nail, can be determined in various possible ways.
  • the expected insertion direction for example, the ideal nail entry direction of the ideal nail entry point of the intramedullary nail
  • the insertion direction provided by the user is the insertion direction provided by the user.
  • the sensor 11 is at the reference position (that is, the medical navigation device 10 is at the reference position)
  • shooting is performed to obtain a medical image.
  • the medical personnel can determine the expected insertion direction such as the ideal nail entry point and the ideal nail entry direction of the intramedullary nail, and then input the expected insertion direction through manual input and other methods, and input the expected insertion direction Determine the expected insertion direction provided to the user, for example, determine the ideal nail entry direction of the ideal entry point of the intramedullary nail provided to the user.
  • the expected insertion direction such as the ideal nail entry direction of the ideal nail entry point of the intramedullary nail
  • the sensor 11 is located at the reference position (that is, the medical navigation device 10 is located at the reference position). location) obtained during shooting.
  • an expected insertion direction such as an ideal nail entry direction of an ideal nail entry point of an intramedullary nail
  • it can also identify the axial direction of the femoral shaft through image processing of medical images, and combine the axial direction of the femoral shaft with the ideal nailing direction of the ideal nailing point of the intramedullary nail. The angle between them (for example 5°) determines the ideal nail entry direction for the ideal nail entry point of the intramedullary nail.
  • the aforementioned “medical images” include but are not limited to X-ray fluoroscopy images or nuclear magnetic resonance imaging.
  • the aforementioned “medical images” can be imaged under X-rays, high-frequency RF transmission and external magnetic fields, ultrasound or gamma rays, or can be imaged in other ways, which are not specifically limited here.
  • the aforementioned target offset position information may be the difference between the specified direction of the sensor 11 at the reference position and the expected insertion direction (such as the ideal nail entry direction) of the target position (such as the ideal nail entry point of the intramedullary nail). angle between.
  • the angle between the specified direction of the sensor 11 at the reference position and the expected insertion direction (such as the ideal nail entry direction) of the target position (such as the ideal nail entry point) of the intramedullary nail it can be Determined in every possible way.
  • the specified direction of the sensor 11 as the axis direction of the medical navigation device 10 as an example, several of them are combined to determine the specified direction of the sensor 11 at the reference position and the expected insertion direction of the target position (such as the ideal nail entry point of the intramedullary nail)
  • the angle between the ideal nail entry direction is given as an example.
  • the medical personnel determine the expected insertion direction (for example, the ideal nail entry direction of the ideal nail entry point of the intramedullary nail) by viewing the medical image, they can combine the medical navigation device 10 displayed on the medical image to use the protractor and other measuring tools capable of measuring angles to measure the angle between the expected insertion direction (such as the ideal nail entry direction of the ideal nail entry point of the intramedullary nail) and the specified direction of the sensor 11 (such as the axis direction of the medical navigation device 10) , the included angle is the included angle between the designated direction of the sensor 11 at the reference position and the expected insertion direction of the target position (for example, the ideal nail insertion direction of the ideal nail insertion point of the intramedullary nail).
  • the expected insertion direction for example, the ideal nail entry direction of the ideal nail entry point of the intramedullary nail
  • the medical staff can record the included angle by themselves to facilitate subsequent use.
  • the medical staff can also input the determined included angle into the medical navigation device 10 and/or the external processing device 20 and/or the external prompting device 30 and/or the navigation processing device 40 by inputting or otherwise, so as to facilitate Subsequent use.
  • the image analysis device can analyze the medical image at the same time to obtain the designation of the sensor 11 direction (such as the axis direction of the medical navigation device 10), and calculate and identify the expected insertion direction (such as the ideal nail entry direction of the ideal nail entry point of the intramedullary nail) and the specified direction of the sensor 11 (such as the axis direction of the medical navigation device 10) In order to obtain the included angle between the designated direction of the sensor 11 at the reference position and the expected insertion direction of the target position (eg, the ideal nail insertion direction of the ideal nail insertion point of the intramedullary nail).
  • the device performing image analysis is a device different from medical navigation device 10 and/or external processing device 20 and/or external prompting device 30 and/or navigation processing device 40, after the device performing image analysis obtains the included angle, it can also The included angle is provided to the medical navigation device 10 and/or the external processing device 20 and/or the external prompting device 30 and/or the navigation processing device 40 in a wired or wireless manner, or it may be provided to the medical staff after knowing it, and the medical staff The personnel input the included angle ⁇ into the medical navigation device 10 and/or the external processing device 20 and/or the external prompting device 30 and/or the navigation processing device 40 to facilitate subsequent use.
  • the second displacement deviation may include: in the direction perpendicular to the horizontal plane, the distance between the real-time position of the sensor 11 and the expected insertion position (for example, the ideal nail insertion position of the ideal nail insertion point of the intramedullary nail).
  • the expected insertion position may be determined based on a predetermined insertion area
  • the predetermined insertion area may refer to an area used to determine the expected insertion position. Taking the ideal insertion point of the intramedullary nail whose target position is the proximal end of the femur as an example, the predetermined insertion area may be the ridge-like outline of the apex of the greater trochanter. The specific location information of the expected insertion location can be determined during the movement of the orthopedic surgical tool fixed to the sensor 11 .
  • the height value of the expected insertion position (such as the ideal nail entry position of the ideal nail entry point of the intramedullary nail) in the direction perpendicular to the horizontal plane is determined by the first reference height value and the second reference height value, wherein,
  • the first reference height value is the height value of the sensor 11 in the direction perpendicular to the horizontal plane when the insertion end of the orthopedic surgery tool is located at the apex of the first side of the predetermined insertion area, and the second reference height value is when the insertion end of the orthopedic surgery tool is located at the predetermined insertion area.
  • the vertex on the first side may refer to the apex of the ridge profile of the apex of the greater trochanter that is closest to the ventral side
  • the apex on the second side may refer to the apex of the greater trochanter
  • the ridged profile is closest to the dorsal apex.
  • the senor 11 can also be used to measure the pitch angle, where the pitch angle is the angle between the bottom surface of the medical navigation device 10 and the horizontal plane, as shown in FIG. 10 .
  • the navigation prompt component 12 of the medical navigation device 10 is also used to prompt the pitch angle measured by the sensor 11 .
  • the medical navigation device 10 may also transmit the pitch angle measured by the sensor 11 to the external prompting device 30 and/or the navigation processing device 40 for prompting.
  • the medical navigation device 10 is also used to provide error prompt information.
  • the error prompt information is information generated when the accumulated duration is longer than the preset duration.
  • the accumulative duration is the duration counted from when the reference position information was recorded or when the sensor 11 was calibrated last time. During the use of the sensor 11, when the use time is too long, it may cause errors. Therefore, it is also possible to count the accumulated time from the time when the reference position information is recorded or when the sensor 11 was calibrated last time. When the accumulated time is greater than the preset time , it is considered that there is an error in the sensor 11, and error prompt information can be provided.
  • the error prompt information is information generated when the calculated error is greater than the error threshold.
  • the medical navigation device 10 can simultaneously monitor and calculate the error of the sensor 11 , and generate an error prompt message when the calculated error is greater than the error threshold.
  • the error threshold can be set according to the accuracy of the sensor 11, etc., which is not specifically limited in this embodiment of the present application.
  • the error prompt information provided by the medical navigation device 10 can be prompted by the navigation prompt component 12 of the medical navigation device 10, and the medical navigation device 10 can also send the error prompt information to the external prompt device 30 and/or the navigation processing device 40, by The external prompting device 30 and/or the navigation processing device 40 provide prompting.
  • the medical staff can also directly select the medical navigation device 10 including other sensors 11 for medical navigation, so as to improve the accuracy of medical navigation.
  • the following will illustrate the process of medical navigation based on the medical navigation device 10 and/or the navigation processing device 40 in a specific surgical process. It should be understood that the descriptions of these embodiments are not intended to limit the applicable orthopedic surgery types of the medical navigation device 10 and/or navigation processing device 40 provided in this application.
  • the medical navigation device 10 and/or navigation processing device 40 provided in this application The processing device 40 is equally applicable to other orthopedic surgeries, and similar processing can be performed based on the medical navigation device 10 and/or the navigation processing device 40 in other orthopedic surgeries.
  • Fractures of the proximal femur such as intertrochanteric fractures
  • fractures of the long bone such as the tibia and humerus
  • intramedullary nailing to facilitate fracture healing.
  • the selection of the position of the intramedullary nail and the direction of the nail is very important. This is because the position and direction of the nail entry will affect the establishment of the reamed channel and the position and direction of the main intramedullary nail. Improper selection will make it difficult for the main nail to enter the medullary cavity, even if it can be forcibly driven into the medullary cavity. , it will also lead to uneven force and large deformation of the main nail in the medullary cavity. At this time, it is easy to damage the fracture reduction effect. It can lead to delayed union or even nonunion or malunion at the fracture site.
  • the ideal nail insertion position is at the apex of the greater trochanter and close to the mid-axis of the femoral neck, as shown in Figure 11, and the ideal insertion direction is the axis of the femoral shaft
  • the outer deflection is 5° to adapt to the outer deflection angle of the main nail, as shown in Figure 12.
  • the position and direction of the nail entry point are usually determined by inserting the guide pin.
  • the entry direction of the main nail in the later stage.
  • the inventors found that in the existing methods of inserting the guide pin, in order to ensure that the inserted guide pin is in a satisfactory nail entry position and direction, it is necessary to insert the guide pin throughout the entire X-ray fluoroscopy is continuously carried out during the process to observe the position and direction of the needle tip in real time, but this method will undoubtedly increase the amount of radiation received by patients and doctors.
  • the fluoroscopic image estimates the position and angle that need to be adjusted, inserts the second guide pin without pulling out the first guide pin, checks the position and direction of the second guide pin through fluoroscopy again, and repeats this process , until after fluoroscopy, it is determined that the inserted guide pin has reached the satisfactory position and direction of the nail.
  • the guide wire inserted for the first time is usually difficult to reach the expected ideal insertion point of the intramedullary nail.
  • the later adjustment process based on the fluoroscopy results also greatly prolongs the operation time, and the adjustment of the position and angle cannot be accurate. Controlling, but also increased the number of fluoroscopy and radiation dose of patients and doctors.
  • the embodiment of the present application provides a light, convenient and easy-to-implement medical navigation device 10 that does not increase the number of fluoroscopy times and radiation doses of patients and doctors.
  • the medical navigation device 10 can be used to guide the movement of the orthopedic surgical tool, for example, it can be used to guide the orthopedic surgical tool to move to an ideal insertion point of the intramedullary nail.
  • the medical navigation device 10 includes a processor 13 and a sensor 11 , and in some embodiments, may also include a navigation prompt component 12 and/or a communication component 14 .
  • a schematic diagram of the appearance of the medical navigation device 10 in some embodiments is shown in FIG. 5 .
  • the sensor 11 integrated in the medical navigation device 10 can be a six-degree-of-freedom inertial sensor, and the sensor 11 is used to measure the position deviation (x, y, z) and angular deviation of the medical navigation device 10 relative to the reference position (alpha, beta, gamma).
  • the definition of the self-coordinate system of the sensor 11 is shown in Figure 6.
  • the sensor 11 After setting the reference position information of the sensor 11, and then moving the sensor 11, the sensor 11 can measure the relative position information of the real-time position of the sensor 11 relative to the reference position, that is, along The displacement of the three coordinate axes (x, y, z) and the angular deviation ( ⁇ , ⁇ , ⁇ ) between the current direction of each coordinate axis and the direction of the reference coordinate axis.
  • the sensor 11 is integrated inside the medical navigation device 10, so the reference position information of the sensor 11 can be used as the reference position information of the medical navigation device 10, the real-time position information of the sensor 11 can be used as the real-time position information of the medical navigation device 10, and the reference position information
  • the reference position of the sensor 11 and/or the medical navigation device 10 is determined, and the real-time position information determines the real-time position of the sensor 11 and/or the medical navigation device 10 .
  • the sensor 11 can also measure the pitch angle of the bottom surface of the medical navigation device 10 relative to the absolute horizontal plane.
  • the medical navigation device 10 may also be integrated with a level, and the level is used to measure the pitch angle of the bottom surface of the medical navigation device 10 relative to the absolute horizontal plane.
  • the medical navigation device 10 is provided with a digital display screen (hereinafter referred to as the screen), on which 3 numbers are displayed, and the symbol “ ⁇ " represents the displacement deviation symbol, which is used to indicate The value adjacent to it is the displacement deviation (such as the first displacement deviation or the second displacement deviation mentioned above), and the symbol “°” indicates that the corresponding value is an angle, which is used to indicate that the value adjacent to it is an angle deviation (eg first angular deviation or second angular deviation as described above) or pitch angle.
  • the screen a digital display screen
  • the symbol " ⁇ " represents the displacement deviation symbol, which is used to indicate The value adjacent to it is the displacement deviation (such as the first displacement deviation or the second displacement deviation mentioned above), and the symbol “°” indicates that the corresponding value is an angle, which is used to indicate that the value adjacent to it is an angle deviation (eg first angular deviation or second angular deviation as described above) or pitch angle.
  • " ⁇ 3" means that the first displacement deviation of the real-time position of the sensor 11 and/or the medical navigation device 10 relative to the reference position is 3, or the real-time position of the sensor 11 and/or the medical navigation device 10
  • the second displacement deviation relative to the expected insertion position is 3.
  • "18°” indicates that the first angular deviation of the real-time position of the sensor 11 and/or the medical navigation device 10 relative to the reference position is 18°, or that the real-time position of the sensor 11 and/or the medical navigation device 10 is relative to the expected insertion direction (e.g.
  • the second angle deviation of the ideal nail entry point (ideal nail entry direction) of the intramedullary nail is 18°
  • "4°" means that the pitch angle is 4°.
  • the determination of the first displacement deviation, the second displacement deviation, the first angular deviation, and the second angular deviation can be combined with the coordinates of the sensor 11 when the sensor 11 and/or the medical navigation device 10 are located at the reference position and the real-time position.
  • the coordinate system of the sensor 11 at the reference position is ⁇ (hereinafter referred to as the reference coordinate system)
  • the coordinate system of the sensor 11 at the real-time position is ⁇ ' (hereinafter referred to as the current coordinate system)
  • the current coordinate system ⁇ ' can be calculated relative to The positional offset and angular offset of the reference coordinate system ⁇ to obtain the above-mentioned first displacement offset, second displacement offset, first angular offset, and second angular offset.
  • the projection of the displacement of the origin of the current coordinate system ⁇ ' relative to the origin of the reference coordinate system ⁇ on the Z axis of the reference coordinate system ⁇ is used as the height difference ⁇ h, as shown in Figure 8
  • the height difference ⁇ h is the above-mentioned first displacement deviation
  • the projection of the X-axis of the current coordinate system ⁇ ' that is, the coordinate axis where the axis direction of the medical navigation device 10 is located, on the XOY plane of the reference coordinate system ⁇
  • the included angle with the X-axis of the reference coordinate system is used as an extremity angle, as shown in FIG.
  • the extremity angle is the above-mentioned first angular deviation.
  • the pitch angle of the plane where the bottom surface of the medical navigation device 10 is located relative to the absolute horizontal plane is taken as the pitch angle, wherein, when the tail (narrow end) is tilted, the deviation is a positive value, and when the head (wide end) is tilted When the deviation is negative, as shown in Figure 10.
  • the intramedullary nails in different parts such as the femoral, tibial, and humeral intramedullary nails, have similar nail entry points, the following uses the proximal femoral intramedullary nail surgery as an example to describe in detail.
  • the usual position of the patient in proximal femoral nailing surgery is the supine position.
  • the medical navigation device 10 Before inserting the guide pin after the skin incision, the medical navigation device 10 needs to be placed at the reference position, for example, placed on the surface of the patient's proximal femur. As shown in FIG. 13 , the medical navigation device 10 remains relatively horizontal at this time.
  • the reference position information of the reference position may be recorded.
  • the reference location information may be recorded by responding to the trigger command by issuing the trigger command from the user.
  • medical personnel such as doctors
  • the medical personnel can issue a trigger instruction by operating the medical navigation device 10, and the medical navigation device 10 receives the trigger instruction and will receive the trigger instruction.
  • the position information measured by the sensor 11 at the time of command is recorded as reference position information.
  • the medical navigation device 10 may first initialize the sensor 11, and record the position information measured by the initialized sensor 11 (ie, the initial position information of the sensor 11) as the reference position information.
  • the medical personnel can issue a trigger command by operating the medical navigation device 10, or can issue a trigger command by operating the external processing device 20/navigation processing device 40 .
  • a trigger instruction is issued by operating the medical navigation device 10
  • the method of recording the reference position information by the medical navigation device 10 is the same as the above method. After the medical navigation device 10 records the reference position information, it can send the reference position information to the external processing device 20 /navigation processing device 40 .
  • the external processing device 20/navigation processing device 40 sends the trigger instruction to the medical navigation device 10 to instruct the medical navigation device 10 to obtain and return the sensor 11 position information measured at this time, and record the position information as reference position information; in other embodiments, if the reference position information is preset position information (such as the zero position information of sensor 11 after initializing sensor ), the external processing device 20/navigation processing device 40 can directly use the preset position information as the reference position information, and at the same time send an instruction to the medical navigation device 10, which is used to instruct the medical navigation device 10 to initialize the sensor 11.
  • the reference position information is preset position information (such as the zero position information of sensor 11 after initializing sensor )
  • the external processing device 20/navigation processing device 40 can directly use the preset position information as the reference position information, and at the same time send an instruction to the medical navigation device 10, which is used to instruct the medical navigation device 10 to initialize the sensor 11.
  • the recorded reference position information may include the reference height of the sensor 11 relative to the horizontal plane, and the designated direction of the sensor 11 (such as the axis direction of the medical navigation device 10). Taking the reference position information as the zero position information as an example, at this time, the height output by the sensor 11 is 0 value. If the navigation prompt component 12 of the medical navigation device 10 prompts the first relative position information in real time, the height difference ⁇ h on the screen of the medical navigation device 10 is displayed as 0, the yaw angle is displayed as 0°, and the pitch angle is close to 0°.
  • the medical personnel use the C-arm device or other transmission equipment to take an anteroposterior view of the proximal femur to obtain medical images, wherein the site to be operated, such as the proximal femur, and the At least part of the structure (for example, axis direction) of the navigation device 10 can be visualized in the medical image.
  • the expected insertion direction (such as the ideal nail entry direction of the ideal nail entry point of the intramedullary nail) can be determined based on the medical image, and the designated direction of the sensor 11 (such as the axis direction of the medical navigation device 10) can be determined at the same time.
  • the angle ⁇ is Target offset position information between the target position (such as the ideal nail entry point of the intramedullary nail) and the reference position of the sensor 11 .
  • the determination of the expected insertion direction (such as the ideal nail entry direction of the ideal nail entry point of the intramedullary nail), the specified direction of the sensor 11 (such as the axis direction of the medical navigation device 10) and the included angle ⁇ can be determined by the medical staff. Personnel are identified by means of marker measurements on medical images.
  • the expected insertion direction (such as the ideal nail entry direction of the ideal nail entry point of the intramedullary nail) can be manually marked on the medical image by medical personnel (such as a doctor), and it can also be Mark the specified direction of the sensor 11 (such as the axis direction of the medical navigation device 10), and use a protractor or other measuring tools capable of measuring angles to measure and obtain the expected insertion direction of the mark (such as the ideal insertion point of the intramedullary nail).
  • medical personnel such as a doctor
  • the specified direction of the sensor 11 such as the axis direction of the medical navigation device 10
  • a protractor or other measuring tools capable of measuring angles to measure and obtain the expected insertion direction of the mark (such as the ideal insertion point of the intramedullary nail).
  • the angle X is determined as the axis direction when the sensor 11 is at the reference position and the expected insertion direction (such as the intramedullary nail The angle ⁇ between the ideal nail entry point and the ideal nail entry direction).
  • the axis of the femoral shaft can be manually marked on the medical image by medical staff (such as a doctor), and the designated direction of the sensor 11 (such as the axis direction of the medical navigation device 10) can also be marked at the same time, And use a protractor or other measuring tools capable of measuring angles to measure and obtain the angle X between the marked axis of the femoral shaft and the designated direction of the sensor 11 (eg, the axis direction of the medical navigation device 10 ).
  • the ideal nail entry point of the proximal femoral intramedullary nail is the ideal direction of the femoral shaft axis deviation of 5° to adapt to the external deviation angle of the main nail, therefore, the included angle obtained by adding 5° to this angle X, That is, the angle ⁇ between the axis direction when the sensor 11 is at the reference position and the ideal nail-introducing direction of the ideal intramedullary nail-introducing point.
  • the expected insertion direction (such as the ideal nail entry direction of the ideal nail entry point of the intramedullary nail), the specified direction of the sensor 11 (such as the axis direction of the medical navigation device 10) and the determination of the included angle ⁇ can also be determined by The way the image is processed is determined.
  • the obtained medical image is imported into the image workstation, and the image processing method is used in the image workstation to automatically recognize the expected insertion direction in the medical image (such as the ideal nail entry direction of the ideal nail entry point of the intramedullary nail) and the designated direction of the sensor 11.
  • the image processing method is used in the image workstation to automatically recognize the expected insertion direction in the medical image (such as the ideal nail entry direction of the ideal nail entry point of the intramedullary nail) and the designated direction of the sensor 11.
  • the axis direction of the medical navigation device 10 analyze and determine the identified expected insertion direction (such as the ideal nail entry direction of the ideal nail entry point of the intramedullary nail) and the specified direction of the sensor 11 (such as the axis direction of the medical navigation device 10 ), and the angle X is determined as the angle ⁇ between the axis direction when the sensor 11 is at the reference position and the expected insertion direction (such as the ideal nail insertion direction of the ideal nail insertion point of the intramedullary nail).
  • the identified expected insertion direction such as the ideal nail entry direction of the ideal nail entry point of the intramedullary nail
  • the specified direction of the sensor 11 such as the axis direction of the medical navigation device 10
  • the angle X is determined as the angle ⁇ between the axis direction when the sensor 11 is at the reference position and the expected insertion direction (such as the ideal nail insertion direction of the ideal nail insertion point of the intramedullary nail).
  • the obtained medical image is imported into an image workstation, and the image processing method is used in the image workstation to automatically identify the axis of the femoral shaft in the medical image and the designated direction of the sensor 11 (such as the axis direction of the medical navigation device 10), and analyze and determine The angle X between the identified axis of the femoral shaft and the specified direction of the sensor 11 (such as the axis direction of the medical navigation device 10), combined with the angle X, and the ideal nailing of the shaft axis of the femur and the ideal nailing point of the intramedullary nail.
  • the angle between the directions determines the angle ⁇ between the axis direction when the sensor 11 is at the reference position and the ideal nail entry direction of the ideal nail entry point of the intramedullary nail, such as adding 5° to the angle X to obtain
  • the included angle is the included angle ⁇ between the axis direction when the sensor 11 is at the reference position and the ideal nail entry direction of the ideal intramedullary nail
  • the image processing method for identifying the ideal nailing direction and/or femoral shaft axis of the ideal intramedullary nailing point in the medical image can be implemented using a pattern recognition algorithm or a deep learning intelligent algorithm, and the embodiments of the present application do not make specific limited.
  • the target offset position information such as the angle ⁇ between the axial direction when the sensor 11 is at the reference position and the ideal nail entry direction of the ideal nail entry point of the intramedullary nail
  • the medical staff such as a doctor
  • the medical personnel can record the angle ⁇ by themselves, or input the angle ⁇ into the Medical navigation device 10 and/or external processing device 20 and/or external prompting device 30 and/or navigation processing device 40 .
  • the medical personnel need to input the included angle ⁇ into the medical navigation device 10 and/or the external processing device 20 and/or the external prompting device 30 and/or the navigation processing device 40 in.
  • the image processing device may be the medical navigation device 10 and/or the external processing device 20 and/or the external prompting device 30 and/or the navigation processing device 40 Itself may also be a device other than the medical navigation device 10 and/or the external processing device 20 and/or the external prompting device 30 and/or the navigation processing device 40 .
  • the image processing device may present the included angle ⁇ so that medical personnel (such as doctors) can know the included angle ⁇ . If the image processing device is different from the medical navigation device 10 and/or the external processing device 20 and/or the external prompting device 30 and/or the navigation processing device 40, the image processing device can also be the angle ⁇ It is transmitted to the medical navigation device 10 and/or the external processing device 20 and/or the external prompting device 30 and/or the navigation processing device 40 in a wired or wireless manner. The angle ⁇ is input into the medical navigation device 10 and/or the external processing device 20 and/or the external prompting device 30 and/or the navigation processing device 40 .
  • the image processing device needs to provide the included angle ⁇ to the medical navigation device 10 and/or the external processing device 20 and/or the external prompting device 30 and/or the navigation processing device 40, for example, the image processing device will The angle ⁇ is transmitted to the medical navigation device 10 and/or the external processing device 20 and/or the external prompting device 30 and/or the navigation processing device 40 in a wired or wireless manner, or the image processing device may provide the included angle ⁇ to After being known by the medical personnel, the medical personnel input the included angle ⁇ into the medical navigation device 10 and/or the external processing device 20 and/or the external prompting device 30 and/or the navigation processing device 40 .
  • the medical navigation device 10 is removed from the body surface of the patient's proximal femur on the affected side, and the medical navigation device 10 is combined with orthopedic surgical tools (such as a guide pin or a gripper or an electric drill, and the guide pin is used as an example in the following embodiments) Explanation) is fixed.
  • orthopedic surgical tools such as a guide pin or a gripper or an electric drill, and the guide pin is used as an example in the following embodiments
  • the schematic diagram of fixing the medical navigation device 10 and the guide pin is shown in Figure 16, wherein, the bottom of the medical navigation device 10 can be provided with a groove to directly connect the medical navigation device 10 and the guide pin.
  • the needle is fixed, and the medical navigation device 10 can also be fixed with the guide needle in other ways. If you choose to use a gripper or an electric drill when inserting the guide pin, the medical navigation device 10 can be directly mounted on the gripper or the electric drill through magnetic attraction, so as to fix the medical navigation device 10 with the gripper or the electric drill, and the medical navigation device 10 and the gripper Or a schematic diagram of fixing the electric drill is shown in FIG. 17 .
  • the ridge-like outline of the apex of the greater trochanter on the affected side is generally along the vertical direction and can be manually touched by the doctor from the incision, as shown by the dotted line in the enlarged part in Figure 18.
  • the doctor holds the guide needle with the medical navigation device 10 fixed and makes its axial direction approximately in the horizontal plane, the pitch angle value on the screen of the medical navigation device 10 or the value provided by the medical navigation device 10 to the external prompting device 30 and/or the navigation processing device 40
  • the value of the pitch angle can assist the doctor to check whether the guide pin is approximately level.
  • the doctor moves the orthopedic surgical tool fixed with the medical navigation device 10, and combines the medical navigation device 10 and/or the prompt of the external prompting device 30 and/or the navigation processing device 40 to move the orthopedic surgical tool to the ideal nail entry point of the intramedullary nail .
  • the sensor 11 of the medical navigation device 10 measures and obtains real-time position information in real time.
  • the medical navigation device 10 determines the height difference ⁇ H between the real-time position of the sensor 11 and the reference position based on the real-time position information measured by the sensor 11 .
  • the medical navigation device 10 determines that the height difference ⁇ H between the real-time position of the sensor 11 and the reference position is the height difference ⁇ h1 (if the medical navigation device 10 performs zeroing processing on the sensor 11 , the height difference ⁇ h1 can actually be the first reference height value h1 ).
  • the medical navigation device 10 determines the height difference ⁇ H between the real-time position of the sensor 11 and the reference position based on the real-time position information measured by the sensor 11. is the height difference ⁇ h2 (if the medical navigation device 10 performs zeroing processing on the sensor 11 , the height difference ⁇ h2 can actually be the second reference height value h2 ).
  • the doctor holds the guide needle approximately horizontally so that the tip moves on the ridge-shaped contour of the apex of the greater trochanter, and the height difference ⁇ H displayed by the medical navigation device 10 in real time will vary from the height difference ⁇ h1 to the height difference ⁇ h2.
  • the medical navigation device 10 performs a zeroing process on the sensor 11, the height H that is actually displayed in real time will vary between the height values h1 to h2.
  • the medical navigation device 10 will transmit the real-time position information measured by the sensor 11 to the external processing device 20 .
  • the external processing device 20 determines the height difference ⁇ H between the real-time position of the sensor 11 and the reference position based on the real-time position information measured by the sensor 11 .
  • the external processing device 20 determines the height difference between the real-time position of the sensor 11 and the reference position based on the real-time position information measured by the sensor 11 ⁇ H is the height difference ⁇ h1 (if the sensor 11 is reset to zero, the height difference ⁇ h1 can actually be the first reference height value h1).
  • the external processing device 20 determines the height difference ⁇ H between the real-time position of the sensor 11 and the reference position based on the real-time position information measured by the sensor 11. is the height difference ⁇ h2 (if the sensor 11 has been reset to zero, the height difference ⁇ h2 can actually be the second reference height value h2).
  • the height difference ⁇ H determined by the external processing device 20 is transmitted to the medical navigation device 10 for prompting.
  • the doctor holds the guide needle approximately horizontally so that the tip moves on the ridge-shaped contour of the apex of the greater trochanter, and the height difference ⁇ H prompted by the medical navigation device 10 in real time will vary between the height difference ⁇ h1 and the height difference ⁇ h2.
  • the medical navigation device 10 performs a zeroing process on the sensor 11, the height H that is actually displayed in real time will vary between the height values h1 to h2.
  • the doctor holds the guide needle approximately horizontally so that the tip moves on the ridge-shaped contour of the apex of the greater trochanter.
  • the medical navigation device 10 determines the height difference ⁇ H, and transmits the determined height difference ⁇ H to the external prompting device 30 for prompting.
  • the height difference ⁇ H prompted by the external prompting device 30 in real time will vary from the height difference ⁇ h1 to the height difference ⁇ h2.
  • the sensor 11 is reset to zero, the height H that is actually presented in real time will vary between the height values h1 to h2.
  • the method of determining the height difference ⁇ H is the same as that of the medical navigation device 10 shown in FIG. 1 , and will not be repeated here.
  • the medical navigation device 10 will transmit the real-time position information measured by the sensor 11 to the navigation processing device 40 .
  • the navigation processing device 40 determines the height difference ⁇ H in real time based on the same manner as the external processing device 20 , and prompts the determined height difference ⁇ H.
  • the navigation processing device 40 can prompt the altitude difference ⁇ H by itself, or it can be transmitted to a prompt device different from the navigation processing device 40 for prompting, for example, combined with the embodiment shown in FIG.
  • the external prompting device 30 in the illustrated embodiment is used for prompting.
  • the doctor holds the guide needle approximately horizontally so that the tip moves on the ridge-shaped contour of the apex of the greater trochanter. Zero processing, the height value H of the real-time prompt will change between the height values h1 to h2.
  • the doctor selects the midpoint of the ridge-like contour of the apex of the greater trochanter as the surgical site, then when the suggested height difference ⁇ H is ( ⁇ h1+ ⁇ h2)/2, or when the sensor 11 has been reset to zero, the suggested height When the value H is (h1+h2)/2, it is the midpoint position of the ridge-like contour of the apex of the greater trochanter, that is, the ideal nailing position of the ideal nailing point of the intramedullary nail.
  • the height difference ⁇ H prompted is ( ⁇ h2- ⁇ h1)/3+ ⁇ h1 (if the height difference is displayed as an integer value, you can or rounded down, the same in the following embodiments), or when the sensor 11 has been reset to zero, when the height value H prompted is (h2-h1)/3+h1, it is the intramedullary nail Ideal entry position for ideal entry point.
  • the ideal nail entry position of the ideal nail entry point for the intramedullary nail can be judged and selected by the doctor in combination with the actual position needs, so it can be applied to different specific requirements for different intramedullary nail products.
  • the angle can be adjusted so that the needle entry direction of the guide wire reaches the ideal nail entry direction of the ideal nail entry point of the intramedullary nail.
  • the doctor keeps the tip of the guide wire at the ideal nail entry point of the intramedullary nail unchanged, and adjusts the deflection angle of the guide wire:
  • the medical navigation device 10 determines the declination angle of the real-time position of the sensor 11 relative to the reference position, and gives a prompt.
  • the external processing device 20 determines the declination angle of the real-time position of the sensor 11 relative to the reference position, and sends the declination angle to the medical navigation device 10 for prompting.
  • the medical navigation device 10 determines the declination angle of the real-time position of the sensor 11 relative to the reference position, and sends the declination angle to the external prompting device 30 for prompting.
  • the navigation processing device 40 determines the declination angle of the real-time position of the sensor 11 relative to the reference position based on the real-time position information measured by the sensor 11, and prompts the declination angle, or sends the declination angle to a different party than the navigation processing device.
  • the prompting device 40 for prompting for example, combined with the embodiment shown in FIG. 3 , and sending to the external prompting device 30 in the embodiment shown in FIG. 3 for prompting.
  • the external deflection angle prompted by 40 is the angle ⁇ between the axis direction of the medical navigation device 10 determined above and the ideal nail insertion direction of the ideal nail insertion point of the intramedullary nail.
  • the insertion direction of the guide needle reaches the intramedullary
  • the ideal nail entry direction of the ideal nail entry point is shown in Figure 24.
  • the doctor can refer to the suggested pitch angle, adjust the anteversion angle of the guide wire properly, and then insert the guide wire.
  • each medical navigation device 10 Taking the orthopedic surgical tool navigating to the ideal nail entry point of the intramedullary nail by prompting the second relative position information as an example, the navigation process of each medical navigation device 10 as described above will be described as an example below.
  • the medical navigation device 10 will prompt the height value in the real-time position information measured by the sensor 11 in real time. Put the tip of the guide needle on the apex of the ridge-shaped contour of the apex of the greater trochanter that is closest to the ventral side.
  • the doctor issues a recording instruction by operating the medical navigation device 10 or voice input, and the medical navigation device 10 records the sensor 11 at this time.
  • the measured first reference height value h1 in other embodiments, the medical navigation device 10 will prompt the height value, and medical personnel (such as doctors) can write down the first reference height value h1 measured by the sensor 11 at this time .
  • the doctor issues a recording instruction by operating the medical navigation device 10 or voice input, and the medical navigation device 10 records the sensor 11 at this time.
  • the medical navigation device 10 will prompt the height value, and medical personnel (such as doctors) can record the second reference height value h2 measured by the sensor 11 at this time.
  • the medical navigation device 10 determines the ideal progress of the intramedullary nail based on the first reference height value h1 and the second reference height value h2.
  • the height value H of the ideal nail entry position of the nail point in the direction perpendicular to the horizontal plane and record the height value H.
  • medical personnel such as doctors
  • the medical personnel record the first reference height value h1 and the second reference height value based on their own.
  • h2 after determining the height H of the ideal nail entry position of the ideal nail entry point in the direction perpendicular to the horizontal plane, input the determined height H into the medical navigation device 10, and the medical navigation device 10 records it.
  • the height H of the ideal nail entry position of the ideal entry point of the intramedullary nail is (h1+h2)/2.
  • the height H of the ideal nail entry position for the ideal entry point of the intramedullary nail is (h2-h1)/3+h1.
  • the doctor holds the guide needle approximately horizontally so that its tip moves on the ridge-shaped contour of the apex of the greater trochanter.
  • the medical navigation device 10 combines the real-time position information of the sensor 11 and the recorded height value H to determine the second displacement deviation , and prompt the second displacement deviation.
  • the medical navigation device 10 will transmit the real-time position information measured by the sensor 11 to the external processing device 20 .
  • the external processing device 20 records the value measured by the sensor 11 at this time based on the recording instructions issued by the medical staff through the operation of the external processing device 20 or voice input.
  • the first reference height h1 in some other embodiments, the medical navigation device 10 and/or the external processing device 20 can prompt the height value, and medical personnel (such as doctors) can record the first value measured by the sensor 11 at this time by themselves.
  • the external processing device 20 records the sensor 11 at this time based on the recording instructions issued by the medical staff through the operation of the external processing device 20 or voice input.
  • the measured second reference height value h2 in some other embodiments, the medical navigation device 10 and/or the external processing device 20 can prompt the height value, and the medical staff (such as a doctor) can record the value measured by the sensor 11 at this time.
  • the external processing device 20 determines the ideal progress of the intramedullary nail based on the first reference height value h1 and the second reference height value h2.
  • the height value H of the ideal nail entry position of the nail point in the direction perpendicular to the horizontal plane and record the height value H.
  • medical personnel such as doctors
  • the medical personnel write down the first reference height value h1 and the second reference height value h2 by themselves
  • the medical personnel record the first reference height value h1 and the second reference height value based on their own. h2.
  • the determined height H is input to the external processing device 20 and recorded by the external processing device 20 .
  • the height H of the ideal nail entry position of the ideal entry point of the intramedullary nail is (h1+h2)/2.
  • the height H of the ideal nail entry position for the ideal entry point of the intramedullary nail is (h2-h1)/3+h1.
  • the doctor holds the guide needle approximately horizontally so that its tip moves on the ridge-shaped contour of the apex of the greater trochanter.
  • the medical navigation device 10 combines the real-time position information of the sensor 11 and the recorded height value H to determine the second displacement deviation , and prompt the second displacement deviation.
  • the medical navigation device 10 determines the second displacement deviation, and transmits the determined second displacement deviation to the external prompting device 30 for prompting.
  • the manner in which the medical navigation device 10 determines the second displacement deviation is the same as the manner in which the medical navigation device 10 determines the second displacement deviation shown in FIG. 1 , and will not be repeated here.
  • the medical navigation device 10 will transmit the real-time position information measured by the sensor 11 to the navigation processing device 40 .
  • the navigation processing device 40 determines and prompts the second displacement deviation in real time based on the same method as the external processing device 20, wherein the medical navigation device 10 can prompt the second displacement deviation by itself, or send the second displacement deviation to a different
  • the prompting device of the navigation processing device 40 provides prompting, for example, it is combined with the embodiment shown in FIG. 3 and sent to the external prompting device 30 in the embodiment shown in FIG. 3 for prompting.
  • the ideal nail entry position to determine the ideal nail entry point of the intramedullary nail, in the process of moving the orthopedic surgery tool, when the second displacement deviation prompted in real time is 0, it can be determined that the intramedullary nail has reached the intramedullary nail.
  • the ideal nail entry position of the ideal entry point of the inner nail is intuitive and convenient.
  • the angle can be adjusted so that the needle entry direction of the guide wire reaches the ideal nail entry direction of the ideal nail entry point of the intramedullary nail.
  • the doctor keeps the tip of the guide wire at the ideal nail entry point of the intramedullary nail unchanged, and adjusts the deflection angle of the guide wire:
  • the medical navigation device 10 determines in real time the second angular deviation of the real-time position of the sensor 11 relative to the target position, that is, the specified direction when the sensor 11 is in the real-time position (such as the axis direction of the medical navigation device 10) The angle between the ideal nail entry direction and the ideal nail entry point of the intramedullary nail, and prompt the second angle deviation.
  • the external processing device 20 determines in real time the second angular deviation of the real-time position of the sensor 11 relative to the target position, that is, the specified direction (such as the axis direction of the medical navigation device 10) and the specified direction of the sensor 11 at the real-time position.
  • the included angle between the ideal nail entry point and the ideal nail entry direction of the intramedullary nail, and the second angle deviation is sent to the medical navigation device 10 for prompting.
  • the medical navigation device 10 determines in real time the second angular deviation of the real-time position of the sensor 11 relative to the target position, that is, the specified direction (such as the axis direction of the medical navigation device 10) and the specified direction of the sensor 11 at the real-time position.
  • the included angle between the ideal nail entry point and the ideal nail entry direction of the intramedullary nail, and the second angle deviation is sent to the external prompting device 30 for prompting.
  • the navigation processing device 40 determines in real time the second angular deviation of the real-time position of the sensor 11 relative to the target position based on the real-time position information measured by the sensor 11, that is, the specified direction (such as the axis direction of the medical navigation device 10) and the specified direction of the sensor 11 at the real-time position.
  • the embodiment shown in FIG. 3 is combined and sent to the external prompting device 30 in the embodiment shown in FIG. 3 for prompting.
  • the doctor keeps the tip of the guide wire at the ideal nail entry point of the intramedullary nail unchanged, and adjusts the deflection angle of the guide wire, when the medical navigation device 10 and/or the external prompting device 30 and/or the navigation processing device When the second angle deviation indicated by 40 is 0, the needle insertion direction of the guide wire reaches the ideal nail insertion direction of the ideal nail insertion point of the intramedullary nail, as shown in FIG. 19 .
  • the doctor can refer to the suggested pitch angle, adjust the anteversion angle of the guide wire properly, and then insert the guide wire.
  • the medical navigation device 10 and/or the navigation processing device 40 provided by the various embodiments of the present application as described above, based on the sensor, by following up and prompting the first height deviation and/or the first angle deviation of the real-time position relative to the reference position, And/or, the second height deviation and/or the second angle deviation realize the selection of the ideal nail entry position and the ideal nail entry direction of the ideal intramedullary nail entry point, and fundamentally realize the ideal intramedullary nail entry during surgery.
  • the precise positioning of the ideal nail entry position and the ideal nail entry direction provides doctors with real-time position information and angle information to ensure that the guide needle can be inserted successfully at one time, without the need to insert the guide needle multiple times for adjustment.
  • the medical navigation device 10 provided by each embodiment of the present application is compact and easy to use, which can greatly shorten the operation time, reduce the X-ray radiation dose of doctors and patients, and improve the operation quality and operation efficiency.
  • the medical navigation device 10 prompts the first relative position information and/or the second relative position information
  • the external prompting device 30/navigation processing device 40 prompts the second relative position information.
  • the first relative position information and/or the second relative position information will be described as an example. In the actual technical implementation process, based on actual technical selection and needs, it can also be provided by the medical navigation device 10, the external prompt device 30 and the navigation processing device 40. Two or three of them simultaneously prompt the first relative position information and/or the second relative position information.
  • the external prompting device 30 and the navigation processing device 40 simultaneously prompt the first relative position information and/or the second relative position information
  • the medical navigation device 10 the external prompting The content prompted by the device 30 and the navigation processing device 40 may or may not be completely the same, which is not specifically limited in this embodiment of the present application.
  • the embodiment of the present application further provides a navigation method of the medical navigation device for guiding orthopedic surgery tools, wherein the medical navigation device is provided with sensors.
  • the navigation method of a medical navigation device for guiding orthopedic surgical tools in some embodiments includes:
  • Step S101 When a trigger instruction is received, record the reference position information measured by the sensor of the medical navigation device when the sensor is at the reference position in response to the trigger instruction.
  • Step S102 In a state where the sensor is fixed to the orthopedic surgical tool, acquire real-time position information of the sensor, and acquire first relative position information and/or second relative position information based on the real-time position information.
  • the first relative position information is the relative position information between the real-time position of the sensor and the reference position, and the real-time position is determined by the real-time position information
  • the second relative position information is the relative position information between the real-time position and the target position
  • the second The relative position information is determined by real-time position information and target offset position information.
  • the target offset position information is used to indicate the relative positional relationship between the reference position and the target position.
  • the target position is determined by the expected insertion position of the orthopedic surgical tool in the human body and/or Or the intended insertion direction is determined.
  • the target position can be determined in combination with the type of orthopedic surgery, for example, the ideal entry point of the intramedullary nail.
  • Step S103 Prompting the first relative position information and/or the second relative position information in real time.
  • the first relative position information combined with the target offset position information, and/or, the second relative position information can be used to assist in guiding the orthopedic surgery tool to move to the target position.
  • the navigation method of a medical navigation device for guiding orthopedic surgery tools in some embodiments includes:
  • Step S201 In a state where the sensor of the medical navigation device is fixed to the orthopedic surgical tool, obtain real-time position information measured by the sensor.
  • Step S202 Send the real-time location information to an external processing device.
  • Step S203 Receive the first relative position information and/or the second relative position information fed back by the external processing device.
  • the first relative position information is the relative position information between the real-time position of the sensor and the reference position where the sensor is located in advance
  • the real-time position is determined by the real-time position information
  • the reference position is determined by the pre-recorded reference position information
  • the reference position information is The position information measured by the sensor obtained by the medical navigation device in response to the trigger instruction and sent to the external processing device
  • the reference position information is the preset position information obtained by the external processing device in response to the trigger instruction.
  • the second relative position information is the relative position information between the real-time position of the sensor and the target position, the second relative position information is determined by the real-time position information and the target offset position information, and the target offset position information is used to indicate the reference position and the target position
  • the target position is determined by the expected insertion position and/or expected insertion direction of the orthopedic surgical tool in the human body.
  • Step S204 Prompting the first relative position information and/or the second relative position information in real time.
  • the first relative position information combined with the target offset position information, and/or, the second relative position information can be used to assist in guiding the orthopedic surgery tool to move to the target position.
  • the navigation method of a medical navigation device for guiding orthopedic surgical tools in some embodiments includes:
  • Step S301 When a trigger instruction is received, record the reference position information measured by the sensor of the medical navigation device when the sensor is at the reference position in response to the trigger instruction.
  • Step S302 In a state where the sensor is fixed to the orthopedic surgical tool, acquire real-time position information of the sensor, and acquire first relative position information and/or second relative position information based on the real-time position information.
  • the first relative position information is the relative position information between the real-time position of the sensor and the reference position, and the real-time position is determined by the real-time position information
  • the second relative position information is the relative position information between the real-time position and the target position
  • the second The relative position information is determined by real-time position information and target offset position information.
  • the target offset position information is used to indicate the relative positional relationship between the reference position and the target position.
  • the target position is determined by the expected insertion position of the orthopedic surgical tool in the human body and/or Or the intended insertion direction is determined.
  • Step S303 Send the first relative position information and/or the second relative position information to an external prompting device, and the external prompting device prompts the first relative position information and/or the second relative position information.
  • the first relative position information combined with the target offset position information, and/or, the second relative position information can be used to assist in guiding the orthopedic surgery tool to move to the target position.
  • the navigation method of the medical navigation device for guiding the orthopedic surgery tool in some embodiments can be executed by the navigation processing device 40, wherein the navigation processing device 40 is communicatively connected with the medical navigation device 10, and the method includes :
  • Step S401 Obtain the real-time position information measured by the sensor sent by the medical navigation device when the sensor is fixed to the orthopedic surgical tool.
  • Step S402 Obtain first relative location information and/or second relative location information based on real-time location information.
  • the first relative position information is the relative position information between the real-time position of the sensor and the reference position where the sensor is located in advance, the real-time position is determined by the real-time position information, the reference position is determined by the pre-recorded reference position information, and the reference position information is The position information measured by the sensor obtained by the medical navigation device in response to the trigger instruction and sent to the navigation processing device, and/or, the reference position information is the preset position information obtained by the navigation processing device in response to the trigger instruction; the second relative position information is the relative position information between the real-time position and the target position, the second relative position information is determined by the real-time position information and the target offset position information, and the target offset position information is used to indicate the relative position relationship between the reference position and the target position,
  • the target location is determined by the intended insertion location and/or intended insertion direction of the orthopedic surgical tool in the human body.
  • Step S403 Prompting the first relative position information and/or the second relative position information in real time.
  • the first relative position information combined with the target offset position information, and/or, the second relative position information can be used to assist in guiding the orthopedic surgery tool to move to the target position.
  • the navigation method of the medical navigation device in each of the above-mentioned embodiments can be applied to orthopedic operations that require insertion of intramedullary nails, such as during orthopedic operations for proximal femoral fractures.
  • the above-mentioned medical The navigation device may be a medical navigation device for navigating an intramedullary nail entry point
  • the above-mentioned target position may be an ideal intramedullary nail entry point
  • the above-mentioned expected insertion position may be an ideal nail entry position of an ideal intramedullary nail entry point
  • the aforementioned expected insertion direction may be an ideal nail insertion direction of an ideal nail insertion point of the intramedullary nail.
  • the above-mentioned reference position information is the position information measured by the sensor obtained in response to the trigger instruction.
  • the above reference position information is the position information measured by the sensor after the sensor is initialized in response to the trigger instruction.
  • the initial position information may be zero position information.
  • the zero position information may refer to that the values of position-related information are all set to 0, for example, the height value is 0, and the like.
  • the first relative position information includes a first displacement deviation and/or a first angular deviation between the real-time position and the reference position.
  • the first displacement deviation may include: the distance between the real-time position of the sensor and the reference position in a direction perpendicular to the horizontal plane.
  • the first displacement deviation may also be referred to as a height difference, as shown in FIG. 8 .
  • the first angular deviation may include: after projecting both the designated direction of the sensor fixed to the orthopedic surgical tool and the designated direction of the sensor at the reference position onto the same plane, the difference between the two projections on the plane angle, as shown in Figure 9.
  • the first angular deviation may also be referred to as a deflection angle.
  • the specified direction of the sensor may be the axis direction of the medical navigation device, and the same plane may specifically be a horizontal plane, which is the same in the following embodiments.
  • the second relative position information includes a second displacement deviation and/or a second angle deviation between the real-time position and the target position (for example, an ideal nail entry point of the intramedullary nail), wherein the target position (for example, the intramedullary nail The ideal nail entry point) is determined by the expected insertion position of the orthopedic surgical tool in the human body (such as the ideal nail entry position of the ideal nail entry point of the intramedullary nail) and/or the expected insertion direction (such as the ideal nail entry position of the ideal nail entry point of the intramedullary nail direction) is confirmed.
  • the target position for example, the intramedullary nail
  • the expected insertion direction such as the ideal nail entry position of the ideal nail entry point of the intramedullary nail direction
  • the second angle deviation includes: after projecting the specified direction of the sensor at the real-time position and the ideal nailing direction of the ideal nailing point of the intramedullary nail onto the same plane, the included angle between the two projections on the plane.
  • the same plane may specifically be a horizontal plane.
  • the expected insertion direction (such as the ideal nail insertion direction of the ideal nail insertion point of the intramedullary nail) can be determined in various possible ways.
  • the expected insertion direction (eg, the ideal nail insertion direction of the ideal nail insertion point of the intramedullary nail) is the insertion direction input by the user.
  • the medical navigation device 10 is at the reference position, a medical image is obtained by shooting, and the medical staff manually marks the expected insertion direction (such as the ideal nail insertion direction of the ideal nail insertion point of the intramedullary nail) on the medical image, and The direction manually marked by the medical staff is used as the expected insertion direction (such as the ideal nail insertion direction of the ideal nail entry point of the intramedullary nail).
  • the expected insertion direction (such as the ideal nail entry direction of the ideal nail entry point of the intramedullary nail) is obtained by analyzing the medical image, and the medical image is obtained when the medical navigation device is at the reference position.
  • the second displacement deviation includes: in the direction perpendicular to the horizontal plane, the distance between the real-time position of the sensor and the target position (for example, the ideal nail insertion position of the ideal nail insertion point of the intramedullary nail).
  • the expected insertion position can be determined based on the predetermined insertion area, and the predetermined insertion area can refer to the area used to determine the target position.
  • the predetermined insertion area can be Ridgeline at the apex of the greater trochanter.
  • the specific location information of the expected insertion location can be determined during the movement of the orthopedic surgical tool fixed to the sensor (or medical navigation device).
  • the height value of the expected insertion position (such as the ideal nail entry position of the ideal nail entry point of the intramedullary nail) in the direction perpendicular to the horizontal plane is determined by the first reference height value and the second reference height value, wherein,
  • the first reference height value is the height value of the sensor in the direction perpendicular to the horizontal plane when the insertion end of the orthopedic surgery tool is located at the apex of the first side of the predetermined insertion area, and the second reference height value is the insertion end of the orthopedic surgery tool located in the predetermined insertion area
  • the first side vertex may specifically refer to the apex of the ridge-like contour of the apex of the greater trochanter that is closest to the ventral side
  • the apex of the second side may specifically refer to the ridge of the apex of the greater trochanter.
  • it may also include:
  • it may also include:
  • it may also include:
  • the error prompt information is the information generated when the cumulative duration is longer than the preset duration, and/or, the error prompt information is the information generated when the calculated error is greater than the error threshold, and the cumulative duration is from when the reference position information is recorded or The amount of time since the last time the sensor was calibrated.
  • an electronic device in one embodiment, is provided, and its internal structure diagram may be as shown in FIG. 24 .
  • the electronic device includes a processor, a memory, a communication interface, a display screen and an input device connected through a system bus.
  • the processor is used to provide calculation and control capabilities.
  • the memory of the electronic device includes a non-volatile storage medium and an internal memory.
  • the non-volatile storage medium stores an operating system and computer programs.
  • the internal memory provides an environment for the operation of the operating system and computer programs in the non-volatile storage medium.
  • the communication interface of the electronic device is used to communicate with an external terminal in a wired or wireless manner, and the wireless manner can be realized through WIFI, an operator network, NFC (Near Field Communication) or other technologies.
  • the display screen of the electronic device may be a liquid crystal display screen or an electronic ink display screen
  • the input device of the electronic device may be a touch layer covered on the display screen, or a button, a trackball or a touch pad provided on the housing of the electronic device , and can also be an external keyboard, touchpad, or mouse.
  • an electronic device including a memory and a processor, wherein a computer program is stored in the memory, and the processor implements the steps of the navigation method of the medical navigation device in any of the above embodiments when executing the computer program.
  • a computer-readable storage medium storing a computer program, and when the computer program is executed by a processor, the steps of the navigation method for the medical navigation device in any of the above-mentioned embodiments are implemented.
  • a computer program product or computer program comprising computer instructions stored in a computer readable storage medium.
  • the processor of the computer device reads the computer instructions from the computer-readable storage medium, and the processor executes the computer instructions, so that the computer device executes the steps of the navigation method for medical navigation devices in any of the above embodiments.
  • any references to memory, storage, database or other media used in the various embodiments provided in the present application may include at least one of non-volatile memory and volatile memory.
  • Non-volatile memory may include read-only memory (Read-Only Memory, ROM), magnetic tape, floppy disk, flash memory or optical memory, etc.
  • Volatile memory can include Random Access Memory (RAM) or external cache memory.
  • RAM can take many forms, such as Static Random Access Memory (SRAM) or Dynamic Random Access Memory (DRAM).
  • a medical navigation system includes: an orthopedic surgery tool, and the medical navigation device and/or the navigation processing device in any one of the above-mentioned embodiments.

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Abstract

L'invention divulgue un dispositif de navigation médicale et un procédé de navigation associé, le dispositif de navigation médicale comprenant un processeur, un capteur et un ensemble d'invite de navigation ; le processeur est utilisé pour enregistrer, en réponse à une instruction de déclenchement, des informations de position de référence mesurées par le capteur lorsque le capteur se situe à une position de référence, acquérir des informations de position en temps réel du capteur lorsqu'il est dans un état dans lequel le capteur est fixé à un outil chirurgical orthopédique, et acquérir, sur la base des informations de position en temps réel, des premières informations de position relative et/ou des secondes informations de position relative, les premières informations de position relative étant des informations de position relative entre la position en temps réel et la position de référence du capteur, les secondes informations de position relative étant des informations de position relative entre la position en temps réel et une position cible, les secondes informations de position relative étant déterminées en fonction des informations de position en temps réel et des informations de position de décalage cible, et les informations de position de décalage cible étant utilisées pour indiquer une relation de position relative entre la position de référence et la position cible ; l'ensemble d'invite de navigation est utilisé pour inviter les premières informations de position relative et/ou les secondes informations de position relative.
PCT/CN2022/130944 2022-03-04 2022-11-09 Dispositif de navigation médicale, dispositif et procédé de traitement de navigation, et système de navigation médicale WO2023165158A1 (fr)

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PCT/CN2022/130944 WO2023165158A1 (fr) 2022-03-04 2022-11-09 Dispositif de navigation médicale, dispositif et procédé de traitement de navigation, et système de navigation médicale

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CN116887776A (zh) 2023-10-13
CN116740309A (zh) 2023-09-12
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CN116740309B (zh) 2024-06-25
CN116687437A (zh) 2023-09-05
WO2023165157A1 (fr) 2023-09-07

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