Over the last years, several methods have been proposed to guide the physician during reduction and fixation of bone fractures. Available solutions often use bulky instrumentation inside the operating room (OR). The latter ones usually consist of a stereo camera, placed outside the operative field, and optical markers directly attached to both the patient and the surgical instrumentation, held by the surgeon. Recently proposed techniques try to reduce the required additional instrumentation as well as the radiation exposure to both patient and physician. In this paper, we present the adaptation and the first implementation of our recently proposed video camera-based solution for screw fixation guidance. Based on the simulations conducted in our previous work, we mounted a small camera on a drill in order to recover its tip position and axis orientation w.r.t our custom-made drill sleeve with attached markers. Since drill-position accuracy is critical, we thoroughly evaluated the accuracy of our implementation. We used an optical tracking system for ground truth data collection. For this purpose, we built a custom plate reference system and attached reflective markers to both the instrument and the plate. Free drilling was then performed 19 times. The position of the drill axis was continuously recovered using both our video camera solution and the tracking system for comparison. The recorded data covered targeting, perforation of the surface bone by the drill bit and bone drilling. The orientation of the instrument axis and the position of the instrument tip were recovered with an accuracy of 1.60± 1.22◦ and 2.03± 1.36 mm respectively.
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