The interlocking of intramedullary nails is a technically demanding procedure which involves an excessive amount of X-ray acquisitions; one study lists as many as 48 to successfully complete the procedure and fix screws into 5 mm holes in the nail. In this work, a novel low cost radiation-free drilling guide is designed to assist surgeons in completing the distal locking procedure without any X-ray acquisitions. Using an augmented reality fluoroscope that coregisters optical and X-ray images, we exploit solely the optical images to detect the drilling guide in order to estimate the tip position in the real-time in X-ray. To evaluate the accuracy of the tip estimation, we tested over 200 random drill guide poses showing a mean tip-estimation error of 1.72 +/- 0.7 mm which is significantly robust for the interlocking. Also, three expert surgeons participated in a preclinical study on dry bone phantom and successfully completed the distal locking 56 out of 60 trials with no X-ray acquisition for guidance and an average time of 2 minutes. These promising results have shown the robustness and accuracy of our method thereby offering a low cost and efficient solution in decreasing the complexity of interlocking of intramedullary nails procedure.     «

The interlocking of intramedullary nails is a technically demanding procedure which involves an excessive amount of X-ray acquisitions; one study lists as many as 48 to successfully complete the procedure and fix screws into 5 mm holes in the nail. In this work, a novel low cost radiation-free drilling guide is designed to assist surgeons in completing the distal locking procedure without any X-ray acquisitions. Using an augmented reality fluoroscope that coregisters optical and X-ray ima...     »