CN118845217A - A fracture reduction path planning method, device and program product - Google Patents

Abstract

The present application relates to the field of intelligent medical treatment, specifically a method, device and program product for planning a fracture reduction path. It includes obtaining a CT image of the patient's fracture site; performing three-dimensional bone reconstruction based on the image to obtain a proximal three-dimensional bone and a distal three-dimensional bone; performing bone reduction simulation on the proximal three-dimensional bone and the distal three-dimensional bone to obtain a fracture reduction planning path; specifically: when the three-dimensional bone at one end is stationary, the reduction path of the three-dimensional bone at the other end is reduced by adjusting the angle and distance as the reduction planning path; or when the three-dimensional bones at both ends are reduced by adjusting the angle and distance respectively, the reduction path is the reduction planning path. The present application can obtain the blood vessels, nerves, muscles, tissues, etc. of the patient's fracture site through three-dimensional reconstruction, which helps to avoid important parts and avoid surgical injuries, and has great clinical value.

Description

A fracture reduction path planning method, device and program product

Technical Field

The present application relates to the field of intelligent medical treatment, and specifically to a method, device, program product and computer-readable storage medium for planning a fracture reduction path.

Background Art

Intraoperative navigation technology is an important technology used in modern medical surgery. It combines preoperative images (such as CT, MRI, etc.) with real-time patient anatomical position information during surgery to provide surgeons with accurate three-dimensional spatial guidance, thereby improving the accuracy, safety and efficiency of surgery. This technology has shown great value in neurosurgery, orthopedics, thoracic surgery and other fields. For example, traditional fracture surgery relies on the surgeon's experience and two-dimensional image guidance (such as X-rays), which has limitations in locating the fracture site, determining the implant position and avoiding damage to surrounding important structures. With the advancement of computer technology, imaging technology and robotics technology, intraoperative navigation systems have emerged, providing more accurate three-dimensional visualization and positioning methods for orthopedic surgery. In fracture surgery, intraoperative navigation can help doctors monitor the position of surgical instruments in real time, accurately reposition the fracture ends, optimize internal fixation implants, reduce surgical complications and shorten the recovery period. Preoperative planning is one of the key steps in the intraoperative navigation process. At this stage, the patient's imaging data is usually used for three-dimensional reconstruction to create a high-precision virtual model of the patient's anatomical structure. This model can not only help surgeons have an in-depth understanding of the surgical area before surgery, but can also be used to simulate surgical pathways, assess surgical risks, design personalized surgical plans, etc., thereby optimizing surgical strategies and improving surgical success rates. However, fracture 3D reconstruction technology still faces many challenges in its implementation. For example, it is a major challenge to accurately align the preoperative 3D reconstruction model with the patient's actual anatomical structure. Factors such as changes in body position and tissue deformation during surgery may lead to deviations between the preoperative plan and the actual situation. Soft tissue impact: The soft tissues around the fracture (such as muscles, blood vessels, and nerves) are difficult to display clearly in two-dimensional or three-dimensional images, which affects the comprehensiveness of surgical planning, especially when the protection of these structures needs to be considered.

Especially for fracture sites, when planning the intramedullary nail installation path through preoperative planning, it is necessary to ensure that the path does not pass through or approach important nerves, blood vessels and other sensitive structures, which is crucial to reducing surgical complications. This requires a deep understanding of the local anatomical structure and precise annotation and avoidance planning on the three-dimensional model. In addition, the state of the soft tissue needs to be considered: the state of the soft tissue (such as swelling, inflammation, scar tissue) and the choice of surgical approach will also affect the implantation path of the intramedullary nail. When planning, it is necessary to comprehensively consider how to minimize damage to the soft tissue to promote postoperative recovery.

Summary of the invention

In view of the above problems, the present invention proposes a method for planning a fracture reduction path, which specifically includes:

Obtain CT images of the patient's fracture site;

Performing three-dimensional skeleton reconstruction based on the image to obtain a proximal three-dimensional skeleton and a distal three-dimensional skeleton;

The proximal three-dimensional skeleton and the distal three-dimensional skeleton are subjected to bone reduction simulation to obtain a fracture reduction planning path; specifically: when the three-dimensional skeleton at one end is stationary, the reduction path of the three-dimensional skeleton at the other end is reduced by adjusting the angle and distance, which is the reduction planning path; or when the three-dimensional skeletons at both ends are reduced by adjusting the angle and distance respectively, which is the reduction planning path.

Furthermore, in the resetting path, resetting is performed by first adjusting the angle and then adjusting the distance; or resetting is performed by first adjusting the distance and then adjusting the angle;

Optionally, when the fracture is an incomplete fracture, reduction is performed by first adjusting the angle and then adjusting the distance; when the fracture is a complete fracture, reduction is performed by first adjusting the distance and then adjusting the angle;

Optionally, the three-dimensionally reconstructed parts also include blood vessels, nerves, muscles, and tissues of the fractured segment;

Optionally, the fracture segment includes one or more of the following: tibial shaft segment, femoral shaft segment, fibular shaft segment, humeral shaft segment, ulna shaft segment, and radial shaft segment;

Optionally, the three-dimensional reconstruction includes surface rendering and/or volume rendering;

Optionally, the 3D reconstruction method adopts one or more of the following: SIFT, SURF, FAST, ORB, DeepMVS, Point MVSNet, MVSnet, R-MVSNet.

The method further includes image clipping, wherein the image clipping clips the image of the three-dimensional skeleton to remove redundant parts to obtain a clipped three-dimensional skeleton, and performs bone resetting simulation on the clipped three-dimensional skeleton;

Optionally, the method further comprises image segmentation, wherein the image segmentation segments the image of the three-dimensional skeleton to obtain segmented three-dimensional skeleton, and performs bone reduction simulation on the segmented three-dimensional skeleton.

The object of the present invention is to provide a method for planning an intramedullary nail installation path, comprising: obtaining a reduction planning path based on the above-mentioned fracture reduction path planning method, obtaining a three-dimensional reduction bone based on the reduction planning path; and planning an intramedullary nail installation path based on the three-dimensional reduction bone, including an opening position, an opening depth, and an opening direction;

Optionally, the planning steps of the intramedullary nail installation path are: first obtaining the proximal bone and distal bone positions of the repositioned bone; and then connecting the proximal bone and distal bone positions to generate N paths, where N is a natural number greater than or equal to 1.

The method further includes path importing, wherein the path importing is to import the planned installation path into the navigation, perform image registration to obtain a registered image, and then perform intramedullary nail installation based on the installation path in the registered image;

Optionally, the registration is to register the intraoperative image of the patient with the image in the planned path to obtain a registered image.

The object of the present invention is to provide a system for planning an intramedullary nail installation path, comprising:

Image import module: used to obtain CT images of the patient's fracture site;

Three-dimensional reconstruction module: used for performing three-dimensional reconstruction of bones based on the image to obtain three-dimensional bones;

Bone resetting module: used for performing bone resetting simulation on the three-dimensional bone to obtain a resetting bone;

Path planning module: used to plan the intramedullary nail installation path based on the bone reduction.

The parts reconstructed by the three-dimensional reconstruction module also include blood vessels, nerves, muscles, and tissues of the fractured segment;

Optionally, the path in the path planning module includes needle entry point design, guide needle depth and angle design;

Optionally, the bone resetting module includes a bone display module for displaying a bone list tool, a three-dimensional image model, an operation tool, and a shortcut key icon tool;

Optionally, the shortcut icon tool includes: a rotation icon, a translation icon, and a turnover icon;

Optionally, the operation tool includes: rotation operation, translation operation, and turnover operation;

Optionally, the bone resetting module includes an automatic resetting module and a manual resetting module; when the healthy side bone is included in the three-dimensional image, the bone is reset by the automatic resetting module or the manual resetting module; when the healthy side bone is not included in the three-dimensional image, the bone is reset by the manual resetting module;

Optionally, the bone reduction module further includes an amplification module, which amplifies the split-screen interface into a full-screen display by receiving a zoom instruction;

Optionally, the display mode of the three-dimensional image model includes an X-Ray mode, a volume rendering mode, and a surface rendering mode;

Optionally, the system further comprises an image clipping module, which is used to clip the three-dimensional skeleton to obtain a clipped three-dimensional skeleton, and perform bone resetting simulation on the clipped three-dimensional skeleton;

Optionally, the image cropping module includes a cropping area selection module for selecting a target area and a non-target area;

Optionally, the cropping area selection module places M anchor points by receiving an anchor point placement instruction, and an area formed by the M anchor points is the target area, where M is a natural number greater than or equal to 3;

Optionally, the image cropping module further includes a posture calibration module for calibrating the posture;

Optionally, the image cropping module further includes an automatic cropping module for automatically calculating the target area and cropping;

Optionally, the image cropping module further includes a reset module for restoring to a state before cropping;

Optionally, the image cropping module further comprises a cutting module for cutting off a selected part by receiving a cutting instruction;

Optionally, the image cropping module further includes an undo module, which undoes the previous operation by accepting an undo instruction;

Optionally, the revocation is performed K times continuously, where K is a natural number less than or equal to 4;

Optionally, the system further comprises an image segmentation module, which segments the image of the three-dimensional skeleton to obtain segmented three-dimensional skeletons, and performs bone reduction simulation on the segmented three-dimensional skeletons;

Optionally, the image segmentation module includes a selection module for selecting bones to be segmented and segmentation tools;

Optionally, the image segmentation module further includes a segmentation module, which performs segmentation by receiving a segmentation instruction;

Optionally, the image segmentation module includes a display module for displaying information, wherein the information includes a three-dimensional image, a skeleton sequence tool, and a segmentation tool;

Optionally, the bone sequence tool includes an add tool, a clear tool, a hide tool, a color tool, and a delete tool;

Optionally, the segmentation tool includes a delineation tool, a resection tool, an island tool, and a volume rendering tool;

Optionally, the path planning module includes a planning display module, and the planning display module displays a three-dimensional image model and a two-dimensional image;

Optionally, the path planning module adds two endpoints by accepting a path adding instruction, and connects the endpoints to generate a path and a path information module;

Optionally, the path planning module generates S paths by receiving a path adding instruction, where S is a natural number less than or equal to 10;

Optionally, the path information module includes a surgical path adding part module, a path adding module, a path deleting module, a path color module, a path hiding or displaying module, a path name module, a path length module, a path diameter module, and a path distance module;

Optionally, the system further comprises a surgery preview module for previewing the surgery planning path.

Optionally, the system further comprises a case management module for displaying cases;

Optionally, the case management module also includes a case adding module, a case deleting module, a case querying module, a case modifying module, and a case restoring module;

Optionally, the system further comprises an imaging device selection module, which is used to select an imaging device, wherein the imaging device comprises an image augmentation device and a tablet device. When the imaging device is an image augmentation device, the module jumps to the image correction module, and when the imaging device is a tablet device, the module jumps to the image calibration module.

Optionally, the image correction module is used for deformity correction of two-dimensional images, and includes: an image import module, an editing module, a next step module, a tool calibration module, an image device replacement module, and a laser positioning module;

Optionally, the image calibration module is used to calibrate the image, including a calibration image import module, a calibration editing module, and a calibration next step module;

Optionally, the system further comprises an image registration module for image registration, comprising a posture acquisition module, wherein the posture acquisition module is used to record relative posture information of the surgical area reference frame and the image register;

Optionally, the image registration module further includes an image register recognition status module, and the image register recognition status module is used to display the status of the image register, when it displays green, it indicates that the image register recognition is normal, and when it displays red, it indicates that the image register recognition is abnormal;

Optionally, the image registration module further includes a reference frame recognition module, which is used to display the reference frame type name and its current recognition status, wherein when the reference frame recognition status is green, it indicates that the reference frame recognition is normal, and when the reference frame recognition status is red, it indicates that the reference frame recognition is abnormal;

Optionally, the posture acquisition module first performs mode confirmation of the image register recognition module and the reference frame recognition module before acquiring information, and performs posture acquisition when it is confirmed that the recognition is normal;

Optionally, the image registration module further includes a registered image import module and a registered image deletion module;

Optionally, the image registration module further includes an image registration editing module for adding, modifying, and deleting identification points of the image register;

Optionally, the system further comprises an image verification module for verifying image accuracy;

Optionally, the system further comprises a two-dimensional and three-dimensional registration module for image registration; comprises a registration display module, and the registration display module comprises a normal mode, a fusion mode, and a longitudinal binary mode;

Optionally, the two-dimensional and three-dimensional registration module further includes a functional module, and the functional module includes a position resetting functional module, a first split-screen display near-end functional module, a first split-screen display far-end functional module, a transparency functional module, and an image fusion functional module;

Optionally, the two-dimensional and three-dimensional registration module further includes a registration module, which obtains a registered image by adjusting the positions of the two-dimensional image and the three-dimensional image;

Optionally, the system further comprises a tool calibration module for calibrating the tool;

Optionally, the tool comprises a sleeve and an intramedullary nail;

Optionally, the system further comprises a path guidance module for performing bone opening and implanting an intramedullary nail based on a path in the path guidance module;

Optionally, the path guidance module includes a path list module for displaying information of the planned path;

Optionally, the path list module includes an automatic path selection module for automatically switching the guidance path;

Optionally, the route guidance module further includes a navigation tool module for displaying navigation information;

Optionally, the navigation tool module includes a navigation tool transparency module and an extension line module;

Optionally, the path guidance module further includes a model transparency module, which is used to set the transparency of the three-dimensional model;

Optionally, the path guidance module also includes a path guidance prompt information module for displaying path distance, target distance, and angle.

The object of the present invention is to provide a computer program product, comprising a computer program/instruction, wherein the computer program/instruction is executed by a processor to implement the above-mentioned method for planning a fracture reduction path or the above-mentioned method for planning an intramedullary nail installation path.

The object of the present invention is to provide a computer device, comprising a memory, a processor, and a computer program stored in the memory including:

The processor executes the computer program to implement the above-mentioned method for planning a fracture reduction path or the above-mentioned method for planning an intramedullary nail installation path.

The object of the present invention is to provide a computer-readable storage medium having a computer program/instruction stored thereon, which, when executed by a processor, implements the above-mentioned method for planning a fracture reduction path or executes the above-mentioned method for planning an intramedullary nail installation path.

Advantages of the present invention:

1. In view of the importance of soft tissues around fractures in surgery, when performing three-dimensional reconstruction, not only the bone part of the fracture site is reconstructed, but also the state of the soft tissue is fully considered. The muscles, nerves, blood vessels and other tissues around the fracture are reconstructed in three dimensions, so that the preoperative planned environment can maximize the restoration of the patient's fracture condition, thereby avoiding surgical injuries, reducing intraoperative risks, improving surgical efficiency, and promoting patient recovery after surgery.

2. Perform intraoperative navigation based on the preoperative planned path, and align the preoperative planning image with the original patient image collected during the operation. Use a reference frame, registrar, coordinate measurer, and optical tracker to detect the target, and obtain the relationship between the patient and the registered image with the planned path based on spatial coordinate conversion. The navigation system can view the guidance path in real time, which helps to improve the accuracy and efficiency of intramedullary nail surgery.

BRIEF DESCRIPTION OF THE DRAWINGS

In order to more clearly illustrate the technical solutions in the embodiments of the present invention, the drawings required for use in the description of the embodiments will be briefly introduced below. Obviously, the drawings described below are only some embodiments of the present invention. For those skilled in the art, other drawings can be obtained based on these drawings without creative work.

FIG1 is a schematic flow chart of a method for planning a fracture reduction path provided by an embodiment of the present invention;

FIG2 is a schematic diagram of a system for planning an intramedullary nail installation path provided by an embodiment of the present invention;

FIG3 is a schematic diagram of a computer device provided by an embodiment of the present invention;

FIG4 is a case management interface in a preoperative planning system provided by an embodiment of the present invention;

FIG5 is an image import interface of a preoperative planning system provided by an embodiment of the present invention;

FIG6 is an image cropping interface of a preoperative planning system provided by an embodiment of the present invention;

FIG7 is an image segmentation interface of a preoperative planning system provided by an embodiment of the present invention;

FIG8 is an image resetting interface of a preoperative planning system provided by an embodiment of the present invention;

FIG9 is a path planning interface of a preoperative planning system provided by an embodiment of the present invention;

FIG. 10 is a preview interface of the preoperative planning path provided in an embodiment of the present invention.

FIG11 is an image calibration interface of an intraoperative navigation system provided by an embodiment of the present invention;

FIG12 is an image registration interface of an intraoperative navigation system provided by an embodiment of the present invention;

FIG13 is an image verification interface of an intraoperative navigation system provided by an embodiment of the present invention;

FIG. 14 is a two-dimensional and three-dimensional registration interface of an intraoperative navigation system provided by an embodiment of the present invention.

DETAILED DESCRIPTION

In order to enable those skilled in the art to better understand the solutions of the present invention, the technical solutions in the embodiments of the present invention will be clearly and completely described below in conjunction with the accompanying drawings in the embodiments of the present invention.

In some of the processes described in the specification and claims of the present invention and the above-mentioned figures, multiple operations that appear in a specific order are included, but it should be clearly understood that these operations may not be executed in the order in which they appear in this article or executed in parallel. The sequence numbers of the operations, such as S101, S102, etc., are only used to distinguish between different operations, and the sequence numbers themselves do not represent any execution order. In addition, these processes may include more or fewer operations, and these operations may be executed in sequence or in parallel. It should be noted that the descriptions of "first", "second", etc. in this article are used to distinguish different messages, devices, modules, etc., do not represent the order of precedence, and do not limit the "first" and "second" to be different types.

FIG1 is a schematic diagram of a fracture reduction path planning method provided by an embodiment of the present invention, specifically comprising:

S101: Obtain CT images of the patient's fracture site;

In one embodiment, the fracture is classified according to whether the fracture site is connected to the outside world, including closed fracture and open fracture; and is classified according to the condition of the fracture line, including incomplete fracture and complete fracture.

Among them, closed fractures are those where the skin or mucous membrane at the fracture site is intact and not connected to the outside world. Open fractures are those where the skin or mucous membrane near the fracture is broken, where the fracture site is connected to the outside world, and bacteria can enter through the wound, which can easily cause infection. Incomplete fractures are those where the integrity or continuity of the bone is only partially interrupted, such as crack fractures and greenstick fractures. Complete fractures are those where the fracture line passes through the periosteum and bone, completely separating the fracture ends.

In one embodiment, the CT image used for three-dimensional reconstruction before surgery is three-dimensional image data including coronal plane, axial plane, and sagittal plane.

S102: Performing three-dimensional skeleton reconstruction based on the image to obtain a proximal three-dimensional skeleton and a distal three-dimensional skeleton;

In one embodiment, the three-dimensional bone reconstruction obtains a proximal three-dimensional bone image and a proximal three-dimensional bone image.

In one embodiment, the three-dimensionally reconstructed part also includes blood vessels, nerves, muscles, and tissues of the fractured segment;

Optionally, the fracture segment includes one or more of the following: a tibial shaft segment, a femoral shaft segment, a fibular shaft segment, a humeral shaft segment, an ulna shaft segment, and a radial shaft segment.

In one embodiment, the three-dimensional reconstruction includes surface rendering and/or volume rendering.

In one embodiment, the 3D reconstruction method adopts one or more of the following: SIFT, SURF, FAST, ORB, Deep MVS, Point MVSNet, MVSnet, and R-MVSNet.

In one embodiment, the present invention reconstructs the fracture site through three-dimensional reconstruction technology to obtain proximal three-dimensional bones and distal three-dimensional bones, and also reconstructs the blood vessels, nerves, muscles and tissues at the fracture site. When performing preoperative planning, important blood vessels or important nerves are avoided to fit the actual surgical environment and prevent the patient's important nerves or blood vessels from being damaged.

In one embodiment, the method further includes image cropping, wherein the image cropping is performed on the image of the three-dimensional skeleton to remove redundant parts to obtain a cropped three-dimensional skeleton, and a bone reduction simulation is performed on the cropped three-dimensional skeleton.

In one embodiment, the method further includes image segmentation, wherein the image segmentation segments the image of the three-dimensional skeleton to obtain segmented three-dimensional skeleton, and performs bone reduction simulation on the segmented three-dimensional skeleton.

S103: Perform bone reduction simulation on the proximal three-dimensional skeleton and the distal three-dimensional skeleton to obtain a fracture reduction planning path; specifically: when the three-dimensional skeleton at one end is stationary, the reduction path of the three-dimensional skeleton at the other end is reduced by adjusting the angle and distance, which is the reduction planning path; or when the three-dimensional skeletons at both ends are reduced by adjusting the angle and distance respectively, the reduction path is the reduction planning path.

In one embodiment, when one end of the three-dimensional bone is stationary, the resetting path of the other end of the three-dimensional bone by adjusting the angle and distance is the resetting planning path; wherein the resetting path is the motion trajectory of the three-dimensional bone at the moving end.

In one embodiment, the reset path after the three-dimensional bones at both ends are reset by adjusting the angle and distance respectively is the reset planning path; the reset path includes the motion trajectory of the three-dimensional bones at both ends or at M, where M is a natural number greater than or equal to 2.

In one embodiment, in the resetting path, resetting is performed by first adjusting the angle and then adjusting the distance; or resetting is performed by first adjusting the distance and then adjusting the angle.

In one embodiment, when the fracture is an incomplete fracture, reduction is performed by first adjusting the angle and then adjusting the distance; when the fracture is a complete fracture, reduction is performed by first adjusting the distance and then adjusting the angle.

In one embodiment, the reduction process is simulated in the planning, and the fracture reduction is achieved through rotation, translation, and turnover tools. The reduction effect can be viewed through 3D surface rendering models, 3D volume rendering models, and x-Ray mode. During the reduction process, when there is a healthy bone (a healthy, uninjured reference bone), the proximal and distal bones of the affected bone can be moved (translated, rotated, and rotated) for reduction; if there is no healthy bone reference, the proximal bone of the fracture is fixed, and the distal bone is moved for reduction. If there is a healthy bone, the system can automatically calculate and perform automatic reduction. After automatic reduction, the user can still manually adjust and perform manual reduction.

The system sets the proximal position of the fracture to be fixed, and achieves anatomical reduction of the fracture through rotation, translation, and turnover. In addition, the system provides automatic registration of the healthy and the patient.

An embodiment of the present invention provides a method for planning an intramedullary nail installation path, comprising:

The method obtains a reduction path based on the above-mentioned fracture reduction path planning method, obtains a three-dimensional reduction bone based on the reduction path; and then plans an intramedullary nail installation path based on the three-dimensional reduction bone, including an opening position, an opening depth, and an opening direction;

In one embodiment, the planning steps of the intramedullary nail installation path are: first obtaining the proximal bone and distal bone positions of the repositioned bone; then connecting the proximal bone and distal bone positions to generate N paths, where N is a natural number greater than or equal to 1.

In one embodiment, the method further includes path importing, wherein the path importing is to import the planned installation path into the navigation, perform image registration to obtain a registered image, and then perform intramedullary nail installation based on the installation path in the registered image;

Optionally, the registration is to register the patient's intraoperative image with the image in the planned path to obtain a registered image.

In one embodiment, the image registration process is:

S1 constructs an image coordinate system through an image system and performs image calibration to obtain a calibrated image coordinate system;

S2 obtains a two-dimensional image of the image register in a calibrated image coordinate system based on the image system;

S3 obtains a first spatial coordinate of an image register based on the two-dimensional image;

S4 constructs an optical tracking coordinate system through an optical tracking positioning system and obtains the second space coordinates of the image register;

S5 performs registration of the optical tracking positioning system and the image coordinate system based on the first spatial coordinates and the second spatial coordinates.

There is a steel column on the image register, and the imaging system obtains a two-dimensional image of the image register by identifying the steel column, and obtains a first spatial coordinate of the image register in a calibrated image coordinate system based on the two-dimensional image.

In one embodiment, S4-S5 is replaced by: constructing an optical tracking coordinate system through an optical tracking positioning system and acquiring the spatial coordinates of a reference frame and the third spatial coordinates of an image register, wherein the reference frame and the image register have a relatively fixed position, calculating the spatial coordinates of the reference frame and the third spatial coordinates to obtain an optical tracking spatial coordinate relationship, calculating the first spatial coordinates in the image coordinate system and the spatial coordinates of the reference frame in the optical tracking coordinate system based on the optical tracking spatial coordinate relationship to obtain a second light and shadow spatial coordinate relationship, and aligning the optical tracking positioning system with the image coordinate system through the second light and shadow spatial coordinate relationship.

The image calibration is completed by a calibrator including N steel balls, where N is a natural number greater than 1. The imaging system obtains the spatial position relationship between the surgical light source and the imaging coordinate system through the N steel balls in the calibrator.

The method also includes image distortion correction, performing image distortion correction on the image coordinate system of the imaging system to obtain a corrected image coordinate system, and performing image calibration on the corrected image coordinate system to obtain a calibrated image coordinate system; wherein the distortion correction is that the imaging system automatically performs correction by acquiring a distortion correction image and based on steel balls arranged in the distortion correction image.

In a specific embodiment, the relationship between the preoperative image and the image register is obtained through the preoperative image coordinates and the image register coordinates in the image coordinate system, the relationship between the two is obtained through the patient coordinates and the image register coordinates in the real coordinate system, and the spatial relationship conversion is performed based on the image register coordinates in the image coordinate system and the real coordinate system to obtain the spatial mapping relationship between the patient coordinates and the preoperative image, and alignment is performed based on this.

In a specific embodiment, the relationship of the preoperative image coordinates in the optical tracking coordinates is obtained through the coordinates of the preoperative image in the image coordinate system and the relationship between the image coordinates and the optical tracking coordinates. The relationship between the patient coordinates and the image registrant coordinates in the real coordinate system is obtained, and the coordinates of the image registrant in the optical tracking coordinate system and the relationship between the preoperative image coordinates in the optical tracking coordinates are spatially transformed to obtain the spatial mapping relationship between the patient coordinates and the preoperative image, and alignment is performed based on this.

In a specific embodiment, the relationship between the preoperative image and the reference frame is obtained by using the reference frame coordinates in the optical tracking coordinate system and the preoperative image coordinates in the image coordinate system, the relationship between the patient and the reference frame is obtained by using the patient coordinates in the real coordinate system and the coordinates of the reference frame, the relationship between the patient and the reference frame is obtained by using the relationship between the preoperative image and the reference frame and the coordinates of the reference frame, a spatial relationship conversion is performed to obtain the relationship between the patient coordinates and the preoperative image, and then alignment is performed.

In a specific embodiment, a real space coordinate system is constructed through a coordinate scanning system to obtain the patient's spatial coordinates and the spatial coordinates of the reference frame, and the relationship between the patient's spatial coordinates and the reference frame's spatial coordinates is obtained. Based on the relationship between the patient's spatial coordinates and the reference frame's spatial coordinates, the relationship between the image coordinate system and the reference frame in the light and shadow tracking coordinate system, and the relationship between the preoperative image and the image coordinates, the relationship between the patient's coordinates and the preoperative image is obtained and aligned.

In a specific embodiment, intraoperative navigation for image registration includes a fluoroscopy machine, a reference frame, an image register, a calibrator, an NDI optical tracker, a display, and a FARO coordinate measuring machine. The reference frame ref1 and the image register ref2 are located next to the surgical site of the patient, the NDI optical tracker and the fluoroscopy machine are located around the patient, and the patient is located within the detection field of view of the NDI optical tracker and the fluoroscopy machine. The calibrator is located at the receiving end of the fluoroscopy machine, and the display is used to display the navigation calibration image.

The embodiments of the present disclosure also provide a computer program product or system, including a computer program, which, when executed by a processor, implements the steps of the above-mentioned method for planning a fracture reduction path, or implements the above-mentioned method steps for planning an intramedullary nail installation path.

FIG2 is a schematic diagram of a system for planning an intramedullary nail installation path provided by an embodiment of the present invention, specifically comprising:

Image import module: used to obtain CT images of the patient's fracture site;

Three-dimensional reconstruction module: used for performing three-dimensional reconstruction of bones based on the image to obtain three-dimensional bones;

Bone resetting module: used for performing bone resetting simulation on the three-dimensional bone to obtain a resetting bone;

Path planning module: used to plan the intramedullary nail installation path based on the bone reduction.

In one embodiment, the path in the path planning module includes the needle entry point design, the depth and angle design of the guide needle.

In a specific embodiment, the system includes case management. After successfully logging into the system, click the "Limb Fracture Reduction Planning" icon to enter the "Case Management" page, which displays the case cards of all current cases, as shown in Figure 4. If there is no case card, it will prompt that there is no surgical plan yet.

Case query: You can enter the patient's name for fuzzy search.

Click the "Add Plan" button to pop up the new surgery window. Fill in the case information. Items with "*" are required. Click the "Confirm" button to successfully add the case and close the pop-up window. Click the "Cancel" button to cancel the case addition operation and close the pop-up window. Click the "Delete" button on the case card to pop up the "Delete Warning" prompt box. Click the "OK" button to delete the surgery plan, close the prompt box, and return to the case management page. Click the "Cancel" button to cancel the deletion operation and return to the case management page. Click the "Edit" button on the case card to pop up the "Edit Surgery" window. Click the "Confirm" button to complete the case card modification and return to the case management page. Click the "Cancel" button to cancel the case card modification and return to the case management page.

In a specific embodiment, image import: click on the case card to enter the "image import" page, where there is no image by default.

Click the "Please import image data" button to open the data management page. In the local examination list, select the required image data, and in the sequence list, click the "Image Import" button to import the image data.

After the image data is imported, it is displayed on four screens, namely: three-dimensional image, two-dimensional image axial plane, two-dimensional image sagittal plane, and two-dimensional image coronal plane, as shown in Figure 5.

Slide the slider in the 2D image area to view different slices. Click the "Re-import" button to open the data management page and re-import the patient's image data.

Click the "Next" button to enter the image cropping page. Click the "Exit" button to exit the image import page and return to the case management page. Click the "Next" button to enter the image cropping page.

In the middle of the image cropping page is the image display area and the image cropping frame. You can adjust the six points of the cropping frame to select the planned surgical site. The lower left corner of the image cropping page displays a diagram of the standard human body posture, which is used as a reference for adjusting the three-dimensional image posture and automatically marking and displaying the bone model. As shown in Figure 6. On the right side of the image cropping page is a floating toolbar, and the function of each tool button is as follows:

Posture calibration: refer to the human body standard posture diagram, adjust the 3D image posture, click the "posture calibration" button to perform posture calibration and load the current posture. After the posture calibration is completed, use the left mouse button to rotate the 3D image, and the human body standard posture diagram will move accordingly.

Automatic cropping: Click the "Auto Crop" button, the system will automatically calculate and retain the surgical area of the current case, such as femur, tibia, and humerus. After automatic cropping, you can still use the resection tool for manual cropping.

Reset: Click the "Reset" button to restore the automatically cropped or cut model to its initial state after the cropping box is selected.

Resection: Click the "Resection" button to manually remove excess parts.

Undo: Click the "Undo" button to undo the last step of the cutting operation, up to 4 times in a row. After completing the image cropping and pose calibration, click the "Next" button to enter the "Image Segmentation" page.

The image segmentation page displays image information in four split screens, which is convenient for observing the segmentation effect from multiple angles. The default first split screen displays: 3D image, bone list, and segmentation tool, as shown in Figure 7.

Bone List Description:

Click the "Add" button to manually add bone fragment labels to display in the bone list. Click the "Clear" button to clear all segmented models and delete all manually added bone fragment labels. Click the Show or Hide button to show/hide the current segmented model. Click the displayed color button to modify the color. When the mouse is placed on a bone label in the bone list, the "Delete" button will be displayed. Click the "Delete" button to delete this bone label. Among them: proximal bones and distal bones cannot be deleted.

Split Tool Description:

Outline: Select the "Outline" button to select the part to be segmented in the 3D image. Click the "Outline" button again to cancel the selection. Resection: Select the "Resection" button to remove the redundant part of the segmented model. Island: Select this tool and click the part to be segmented in the 3D image. If the segmented part is not connected to other parts, the segmentation can be completed directly. Volume Rendering: Click this button to set the display or hiding of the volume rendering model.

Image segmentation steps:

1) Select the bone label to be segmented in the bone list, such as the proximal bone;

2) Select the segmentation tool you want to use, such as sketching;

3) In the 3D image volume rendering, check the proximal bone area;

4) After the check is completed, the page prompts: "Generating, please wait...", and the prompt disappears, indicating that the segmentation is complete.

The bone resetting page is displayed in three parts, which is convenient for observing the resetting effect from multiple angles. As shown in Figure 8, the first part shows: bone list, 3D image model, operation tools, and mouse shortcut icons. Double-click any part to enlarge it to full screen.

Select the skeleton model, select the "Translate" button, and use the left mouse button to translate the skeleton model.

Select the skeleton model, select the "Rotate" button, and use the left mouse button to rotate the skeleton model.

Select the skeleton model, select the "Turnaround" button, and use the left mouse button to perform a rotation operation on the skeleton model.

Click the "X-Ray" button to display the image data in X-Ray mode. Click again to cancel the X-Ray mode. You can also reset the X-Ray mode. Click the "Volume Rendering" button to set the display or hiding of volume data. You can also reset the volume rendering data mode.

Bone reduction operation instructions:

1) When there is healthy bone, the system will automatically reset when you enter the bone reset page for the first time. You can also click the "Reset" button to automatically reset. After automatic reset, you can still manually reset.

2) When there is no healthy bone, the proximal bone is fixed and the distal bone can be rotated, translated, and rotated for manual reduction.

Path planning after bone reduction: The bone reduction page displays images in four split screens, namely: 3D image model, axial plane 2D image, sagittal plane 2D image, and coronal plane 2D image, as shown in Figure 9. Double-click any split screen to enlarge it to full screen display.

Click the "Add Path" button to add two points on the 2D image to generate a path. After adding the path, the current path information is displayed in the path list. If you add multiple paths, click the "Add Path" button again to automatically generate a path parallel to the previous one. Drag it to the appropriate position. You can add up to 10 paths. Check the proximal or distal button to specify the location of the surgical path. The proximal is checked by default. Click the Add Path button to add a surgical path in the workspace. Click the Delete button to delete the path. Click the Current Path Color button, which is randomly generated by the system. Click this color to modify it. Click the Show/Hide button to set the display or hide of the current path; the Current Path Name button is automatically generated by the system, P: proximal, D: distal. Current Path Length button, click the up and down buttons to adjust the path length. Current Path Diameter button, default 3mm, maximum 30mm, click the up and down buttons to adjust the path diameter. Path Distance Button: Calculate the shortest distance between two adjacent paths. The default path distance for the first path is 0. For the second and subsequent paths added, the system automatically calculates and displays the path distance with the previous path. If the first path is deleted, the path distance display of the next path becomes 0, and the distance display of other paths remains unchanged. If a path in the middle is deleted, the path distance of the next path is automatically calculated and redisplayed.

In a specific embodiment, the surgical plan preview function interface mainly includes a surgical plan three-dimensional model display, a left floating toolbar, and a right floating toolbar, as shown in Figure 10. The reset coordinate axis is displayed on the three-dimensional model in the middle of the interface and can be adjusted manually.

In a specific embodiment, the preoperative planning path is imported into the intraoperative navigation system:

Add ROM: Click the "Add ROM" button, open the local folder, select a ROM file, and add the new ROM file to the ROM list.

Add navigation tool: Click the "Add Navigation Tool" button, open the local folder, select the navigation tool file to be added, and add the information (data + model) folder corresponding to the new navigation tool to the tool list. After successful addition, the prompt will be: Upload successful.

Add calibration tool: Click the "Add calibration tool" button, open the local folder, select the calibration tool file to be added, and add the information (data + model) folder corresponding to the new calibration tool to the calibrator list.

ROM list: The ROM list displays the imported ROM information. Click to select a ROM information to select the ROM used in the operation for the reference frame.

In the tool list, the navigation tools used in this technique are displayed.

Click the "Save" button to complete the tool information modification. Click the "Close" button to close the tool management page. Calibrator list: In the calibration list, the calibrators used in this procedure are displayed. In the 2D and 3D navigation mode, click the "Spinal Surgery Navigation" procedure icon to pop up the tool management page, where you can manage the tool information used in the spinal surgery navigation procedure.

Log in to the Xinghang Surgical Navigation System with a user account. On the procedure management page, click the "2D-3D" button to display the procedure icons in the two- and three-dimensional navigation modes. Click the "Limb Fracture Reduction Navigation" procedure icon to enter the "Case Management" page.

On the case management page, the case cards of all current cases are displayed. If there is no case card, it will prompt that there is no case. Users can add new case cards, query cases, delete cases, and restore cases. Case query: Users can enter the patient's name for fuzzy query, and the query results are displayed in the case list. Click the "Add Case" button, open the local folder, select the V3D file exported by the limb fracture reduction plan, and click Upload. The case cards in the case list are arranged in reverse order according to the import time. Delete button: Click the "Delete" button on the case card, and the "Delete Warning" prompt box will pop up. If you click the "Move to Recycle Bin" button, you can move the current case to the Recycle Bin. If you click the "Delete Completely" button, all contents including the two-dimensional image and V3D file in the current case will be deleted immediately. Once the data is completely deleted, it will not be recoverable. Modify button: Click the "Modify" button on the case card, and the "Modify Case" window will pop up. Click the "Confirm" button to complete the case card modification and return to the case management page. Click the "Cancel" button to cancel the modification of the case card and return to the case management page. Restore button, click this button to restore this case card from the recycle bin and display it in the case management list. After the restoration is completed, the page prompts: Restoration completed. Click the "Close" button to close the recycle bin page and return to the case management page.

In a specific embodiment, on the case management page, click on the case card and first select the imaging device used in the surgical navigation process. If you select an image augmentation device, enter the distortion correction page. If you select a tablet device, directly enter the image calibration page. If the imaging device has already been selected for this case, you can ignore this step and directly proceed to the next step. If you select an image augmentation device, enter the distortion correction page to perform distortion correction on the two-dimensional image to solve the image distortion problem of the image augmentation device.

On the distortion correction page, click the "Import" button to open the folder where the distortion correction image is located and import the distortion correction image. After the image is imported, the Xinghang surgical navigation system automatically identifies each steel ball in the image and automatically corrects the distorted original image. As shown in the figure below, the image on the left is the original image, and the image on the right is the image after distortion correction.

On the image calibration page, the image calibration page is displayed in two split screens, the left side displays: frontal calibration image, and the right side displays: lateral calibration image.

The image calibration page has no image by default. Next button: After completing the image calibration, click this button to enter the next image registration page. If the image calibration has not been performed, a prompt will appear: Please complete the image calibration first. Import calibration images: Click the "Import Orthogonal" button to open the folder where the orthogonal calibration images are located and import the orthogonal calibration images; click the "Import Lateral" button to import the lateral calibration images.

After the calibration image is imported, the Xinghang surgical navigation system automatically identifies each steel ball in the calibration image. If there are unrecognized or incorrectly recognized steel balls, click the "Edit" button to adjust them. As shown in Figure 11 below. Edit the calibration image: Scroll the middle mouse button to zoom in and out of the calibration image. The black dot is the steel ball image on the calibration image, and the green circle is the identification point of the Xinghang surgical navigation system. Use the left mouse button to hold down the identification point, move this identification point, and overlap it with the steel ball image to adjust the recognition accuracy of the calibration image. After the identification point is selected, it will turn from green to blue and can be moved at will. Click in a blank space to cancel the selection of the identification point.

Edit page button description:

Add point: Click the "Add point" button, then click on the calibration image to add an identification point. Use the left mouse button to hold down the identification point and move it to the unidentified steel ball image to identify the unidentified steel ball on the image.

Delete point: Click to select the identification point on the calibration image, and then click the "Delete point" button to delete the identification point.

Cancel: Click the "Cancel" button to cancel the editing state, not save the modified content, and return to the image calibration page.

Finish: Click the “Finish” button to save the modified content and return to the image calibration page.

In a specific embodiment, image registration: the image registration page is displayed in four split screens, and the four split screen images are respectively: proximal anteroposterior image, distal anteroposterior image, stump anteroposterior image, and stump lateral image. Each split screen image can be imported, deleted, edited, and position and posture acquisition operations can be performed separately, as shown in Figure 12.

Image registration page button function description:

Import: Click the "Import" button to import the Dicom image of the corresponding surgical area. Delete: Click the "Delete" button to delete the current image. Posture Collection: Click the "Posture Collection" button to record the relative posture information of the reference frame and image register of the corresponding surgical area. When collecting posture, please make sure that the fixed bone, mobile bone and image register on the right side of the page are displayed in green.

To edit a registered image:

Double-click the current image to start the editing state: use the mouse wheel to zoom in and out the image, use the left key to move the image, and use the right key to adjust the window width and window position. Add optical ball: add the unrecognized optical ball outline on the register. Add steel ball: add the unrecognized steel ball outline on the register. Zoom in and out: adjust the diameter of the optical ball or steel ball outline. Delete point: delete the identification point in the image. Cancel: abandon the operation and return to the initial entry state. Complete: confirm the operation and return to the image registration interface. Click the "Next" button to enter the image verification page.

The image verification page displays image information in two split screens. The first split screen displays the proximal/distal anteroposterior images, and the second split screen displays the stump anteroposterior images, as shown in Figure 13 below.

Remote image verification method:

First, click the "Remote Verification" button to display the distal anteroposterior image in the first split screen;

Secondly, adjust the position of the optical positioner to ensure that the patient reference frame and probe are within the optical positioner recognition range. If the patient reference frame and probe icons on the right side of the page are displayed in green, the patient reference frame and probe can be recognized normally; if they are displayed in red, the patient reference frame and probe cannot be recognized normally.

Then, use the probe to touch the patient's feature points. In the system software, if the probe model touches the same feature point position of the patient's three-dimensional model, the image verification is passed.

Proximal image verification method: Click the "Proximal Verification" button, and the first split screen will display the proximal anteroposterior image. Use the above-mentioned distal image verification method to verify the proximal image.

In a specific embodiment, two-dimensional and three-dimensional registration: the image verification page displays the image information in three parts, the first part displays the proximal/distal anteroposterior images, the second part displays the stump anteroposterior images, and the third part displays the stump lateral images, as shown in FIG14 below.

Page button function description:

Reset Position: Click this button to restore the 3D image to its initial state.

Proximal: Click this button to display the proximal AP image in the first split screen.

Distal: Click this button to display the distal anteroposterior image in the first split screen.

Registration: Click this button and the system will perform the registration operation.

The display modes of 3D models and 2D images include normal mode, fusion mode, and longitudinal binary mode. The registration results can be viewed, and the default mode is normal mode.

Transparency button: Slide the slider to set the transparency of the 3D model. 0%: completely transparent.

Fusion: Click the "Fusion" button and select the fusion mode. The 3D image is displayed in red and the 2D image is displayed in green. Slide the slider to adjust the color depth of the 3D model.

Vertical Binary Split: Click the "Vertical Binary Split" button to select the vertical binary split mode. Each split-screen 3D model and 2D image are displayed in layers, with each layer showing half. Slide the slider to adjust the display ratio of the upper and lower 3D models and 2D images.

3D model and 2D image registration:

1) Click the "Proximal" button to display the proximal anteroposterior 2D image in the first split screen.

2) Press the left button to rotate the 3D model, and press the middle button to move the 3D model, so that the outline of the 3D model is roughly aligned with the outline of the 2D image.

3) Click the "Register" button to perform the registration operation. You can click the "Register" button multiple times to perform the registration operation.

4) The registration results can be viewed in normal mode, fusion mode, and longitudinal binary mode.

5) Click the "Far" button to display the far-end anteroposterior 2D image in the first split screen and repeat the above steps.

Click the "Next" button to enter the reset and opening guidance page.

In a specific embodiment, on the reduction and opening guide page, click the "fracture reduction" button at the bottom of the page to enter the fracture reduction page. The fracture reduction page displays the three-dimensional model in three screens. Double-clicking any split screen can enlarge the split screen to full screen display.

Reset prompt information:

According to the prompt information, perform reduction adjustment (proximal bone fixation, distal bone movement), as shown below:

1. Axial displacement: The reduction distance of the distal bone along the vertical axis, unit: MM; alignment is 0, separation is positive, and overlap is negative.

2. Internal and external displacement: the reduction distance of the proximal bone and the distal bone along the coronal axis, unit: MM; alignment is 0, displacement to the left is positive, and displacement to the right is negative.

3. Anterior-posterior displacement: The reduction distance of the proximal and distal bones along the sagittal axis, in MM; alignment is 0, anterior displacement is positive, and posterior displacement is negative.

4. Axial rotation: The rotation angle of the distal bone along the vertical axis, unit: °; alignment is 0, internal rotation is positive, and external rotation is negative.

5. Lateral angulation: coronal plane angulation, unit: °; alignment is 0, inward is positive, outward is negative.

6. Anterior-posterior angle: sagittal plane angle, unit: °; alignment is 0, forward is positive, and backward is negative.

In one embodiment, the process of placing an intramedullary nail using navigation:

Sleeve calibration, intramedullary nail calibration, path guidance, intramedullary nail implantation, nail locking, intramedullary nail calibration.

FIG3 is a schematic diagram of a computer device provided by an embodiment of the present invention, specifically comprising:

A memory and a processor; the memory is used to store program instructions; the processor is used to call the program instructions, and when the program instructions are executed, the above-mentioned method for planning a fracture reduction path, or the above-mentioned method for planning an intramedullary nail installation path.

A computer-readable storage medium stores a computer program, and when the computer program is executed by a processor, the method for planning a fracture reduction path or the method for planning an intramedullary nail installation path is implemented.

The verification results of this verification embodiment show that assigning inherent weights to indications can improve the performance of the method relative to the default setting. Those skilled in the art can clearly understand that for the convenience and simplicity of description, the specific working processes of the systems, devices and units described above can refer to the corresponding processes in the aforementioned method embodiments, and will not be repeated here. In the several embodiments provided in this application, it should be understood that the disclosed systems, devices and methods can be implemented in other ways. For example, the device embodiments described above are only schematic, for example, the division of the units is only a logical function division, and there may be other division methods in actual implementation, such as multiple units or components can be combined or integrated into another system, or some features can be ignored or not executed. Another point is that the coupling or direct coupling or communication connection between each other shown or discussed can be through some interfaces, indirect coupling or communication connection of devices or units, which can be electrical, mechanical or other forms. The unit described as a separate component may or may not be physically separated, and the component displayed as a unit may or may not be a physical unit, that is, it may be located in one place, or it may be distributed on multiple network units. Some or all of the units can be selected according to actual needs to achieve the purpose of the scheme of this embodiment. In addition, each functional unit in each embodiment of the present invention may be integrated into one processing unit, or each unit may exist physically separately, or two or more units may be integrated into one unit. The above-mentioned integrated unit may be implemented in the form of hardware or in the form of software functional units. A person of ordinary skill in the art may understand that all or part of the steps in the various methods of the above-mentioned embodiments may be completed by instructing the relevant hardware through a program, and the program may be stored in a computer-readable storage medium, and the storage medium may include: a read-only memory (ROM), a random access memory (RAM), a disk or an optical disk, etc.

A person skilled in the art can understand that all or part of the steps in the above-mentioned embodiment method can be implemented by instructing related hardware through a program, and the program can be stored in a computer-readable storage medium. The above-mentioned medium storage can be a read-only memory, a disk or an optical disk, etc.

The above is a detailed introduction to a computer device provided by the present invention. For a person skilled in the art, according to the concept of the embodiments of the present invention, there may be changes in the specific implementation method and application scope. In summary, the content of this specification should not be understood as limiting the present invention.

Claims (10)

1. A method of planning a fracture reduction path, the method comprising:

Acquiring CT images of fracture parts of patients;

Performing bone three-dimensional reconstruction based on the image to obtain a near-end three-dimensional bone and a far-end three-dimensional bone;

Performing bone reduction simulation on the proximal three-dimensional bone and the distal three-dimensional bone to obtain a fracture reduction planning path; the method comprises the following steps: when one end of the three-dimensional skeleton is static, the reset path of the other end of the three-dimensional skeleton, which is reset through adjusting the angle and the distance, is a reset planning path; or when the three-dimensional bones at the two ends respectively pass through the angle and the distance, the reset path for resetting is a reset planning path.

2. The method for planning a fracture reduction path according to claim 1, wherein the reduction path is reset by adjusting an angle and then adjusting a distance; or resetting by adjusting the distance and then adjusting the angle;

or when the fracture is incomplete fracture, the angle is adjusted first and then the distance is adjusted for resetting; when the fracture is a complete fracture, the distance is adjusted first and then the angle is adjusted for resetting;

The three-dimensional reconstructed part also comprises blood vessels, nerves, muscles and tissues of the fracture segment;

The fracture segment comprises one or more of the following: a tibial diaphysis segment, a femoral diaphysis segment, a fibular diaphysis segment, a humeral diaphysis segment, an ulna diaphysis segment, and a radius diaphysis segment;

the three-dimensional reconstruction comprises surface drawing and/or volume drawing;

The three-dimensional reconstruction method adopts one or more of the following steps: SIFT, SURF, FAST, ORB, deep MVS, point MVSNet, MVSnet, R-MVSNet.

3. The method for planning a fracture reduction path according to claim 1, further comprising image clipping, wherein the image clipping clips an image of the three-dimensional bone to remove redundant parts to obtain a clipped three-dimensional bone, and performing bone reduction simulation on the clipped three-dimensional bone;

The method further comprises image segmentation, wherein the image segmentation is used for segmenting an image of the three-dimensional skeleton to obtain a segmented three-dimensional skeleton, and skeleton reduction simulation is carried out on the segmented three-dimensional skeleton.

4. A method of planning an intramedullary nail installation path, comprising:

the method is based on the fracture reduction path planning method of any one of claims 1-3 to obtain a reduction planning path, and based on the reduction planning path, a three-dimensional reduction skeleton is obtained; planning an intramedullary nail installation path based on the three-dimensional reduction skeleton, wherein the intramedullary nail installation path comprises an opening position, an opening depth and an opening direction;

The intramedullary nail installation path planning steps are as follows: firstly, acquiring the positions of a proximal bone and a distal bone of the reduction skeleton; and then connecting the proximal bone and the distal bone to generate N paths, wherein N is a natural number greater than or equal to 1.

5. The method of planning an installation path of an intramedullary nail according to claim 4, further comprising path introduction, wherein the path introduction is to perform image registration after guiding the planned installation path to obtain a registration image, and performing intramedullary nail installation based on the installation path in the registration image;

The registration is to register the intra-operative image of the patient with the image in the planned path to obtain a registration image.

6. A system for planning an intramedullary nail installation path, comprising:

The image importing module: CT images of fracture parts of patients are acquired;

and a three-dimensional reconstruction module: the method comprises the steps of performing three-dimensional bone reconstruction based on the image to obtain a three-dimensional bone;

a bone reduction module: the bone reduction simulation device is used for carrying out bone reduction simulation on the three-dimensional bone to obtain a reduction bone;

and a path planning module: for planning an intramedullary nail installation path based on the reduction bone.

7. The system for planning an intramedullary nail installation path of claim 6, wherein the site reconstructed by the three-dimensional reconstruction module further comprises a vessel, nerve, muscle, tissue of a fractured segment;

The path in the path planning module comprises a needle insertion point design and a guide needle depth and angle design;

The skeleton resetting module comprises a skeleton display module used for displaying a skeleton list tool, a three-dimensional image model, an operation tool and a shortcut key graphic tool;

The shortcut key pictorial tool includes: a rotation diagram, a translation diagram and a turnover diagram;

the operation tool includes: rotation operation, translation operation, turnover operation;

The skeleton resetting module comprises an automatic resetting module and a manual resetting module; when the three-dimensional image comprises a bone with a healthy side, resetting is carried out through an automatic resetting module or a manual resetting module; when the three-dimensional image does not comprise the bone with the healthy side, resetting is carried out through the manual resetting module;

The skeleton resetting module further comprises an amplifying module which amplifies the split-screen interface to be displayed in a full screen by receiving an amplifying instruction;

The display mode of the three-dimensional image model comprises an X-Ray mode, a volume drawing mode and a surface drawing mode;

The system also comprises an image clipping module, a three-dimensional bone clipping module and a bone resetting module, wherein the image clipping module is used for clipping the three-dimensional bone to obtain a clipped three-dimensional bone and performing bone resetting simulation on the clipped three-dimensional bone;

the image clipping module comprises a clipping area frame selection module used for selecting a target area and a non-target area;

The clipping region framing module is used for placing M anchor points by receiving an anchor point placing instruction, wherein a region formed by the M anchor points is a target region, and M is a natural number which is more than or equal to 3;

The image clipping module further comprises a pose calibration module for calibrating the pose;

the image clipping module further comprises an automatic clipping module, which is used for automatically calculating a target area and clipping;

the image clipping module further comprises a resetting module for recovering to a state before clipping;

The image clipping module further comprises a cutting module for cutting the selected part by receiving a cutting instruction;

the image clipping module further comprises a revocation module, wherein the revocation module is used for performing one-step operation by receiving a revocation instruction;

the revocation is continuously executed for K times, wherein K is a natural number smaller than or equal to 4;

the system also comprises an image segmentation module, wherein the image segmentation module segments the image of the three-dimensional bone to obtain a segmented three-dimensional bone, and performs bone reduction simulation on the segmented three-dimensional bone;

The image segmentation module comprises a selection module, a segmentation module and a segmentation module, wherein the selection module is used for selecting bones to be segmented and segmentation tools;

the image segmentation module further comprises a segmentation module, and segmentation is carried out by receiving a segmentation instruction;

The image segmentation module comprises a display module and a display module, wherein the display module is used for displaying information, and the information comprises a three-dimensional image, a bone sequence tool and a segmentation tool;

The bone sequence tools comprise an adding tool, a clearing tool, a hiding tool, a color tool and a deleting tool;

The segmentation tool comprises a sketching tool, a cutting tool, an island tool and a volume drawing tool;

the path planning module comprises a planning display module, and the planning display module displays a three-dimensional image model and a two-dimensional image;

The path planning module adds two endpoints by receiving a path adding instruction and is connected with the endpoint to generate a path and a path information module;

the path planning module generates S paths by receiving a path adding instruction, wherein S is a natural number less than or equal to 10;

The path information module comprises an operation path adding part module, an adding path module, a deleting path module, a color path module, a path hiding or displaying module, a path name module, a path length module, a path diameter module and a path distance module;

The system also comprises a surgery previewing module, which is used for previewing the surgery planning path;

the system also comprises a case management module for displaying cases;

the case management module further comprises a case adding module, a case deleting module, a case inquiring module, a case modifying module and a case recovering module;

the system also comprises an image equipment selection module, an image correction module and an image calibration module, wherein the image equipment selection module is used for selecting image equipment, the image equipment comprises image adding equipment and flat-panel equipment, when the image equipment is additionally provided for an image, the image equipment is jumped to the image correction module, and when the image equipment is the flat-panel equipment, the image equipment is jumped to the image calibration module;

the image correction module is used for correcting deformity of two-dimensional images and comprises: the device comprises an image importing module, an editing module, a next module, a tool calibration module, an image equipment replacing module and a laser positioning module;

The image calibration module is used for calibrating images and comprises a calibration image importing module, a calibration editing module and a calibration next-step module;

The system also comprises an image registration module, a pose acquisition module and a control module, wherein the image registration module is used for registering images and comprises a pose acquisition module, and the pose acquisition module is used for recording relative pose information of the surgical area reference frame and the image registrar;

The image registration module further comprises an image register identification state module, wherein the image register identification state module is used for displaying the state of the image register, and when the image register is displayed in green, the image register identification is normal, and when the image register is displayed in red, the image register identification is abnormal;

The image registration module further comprises a reference frame identification module for displaying the type name and the current identification state of the reference frame, wherein when the identification state of the reference frame is green, the identification of the reference frame is normal, and when the identification state of the reference frame is red, the identification of the reference frame is abnormal;

before the pose acquisition module acquires information, the mode of the image registrar recognition module and the reference frame recognition module is confirmed, and pose acquisition is carried out when the recognition is confirmed to be normal;

The image registration module further comprises a registered image import module and a registered image deletion module;

the image registration module further comprises an image registration editing module for adding, modifying and deleting identification points of the image registrar;

the system further comprises an image verification module, the method is used for verifying the image accuracy;

The system also comprises two three-dimensional registration modules, which are used for registering images; the system comprises a registration display module, wherein the registration display module comprises a common mode, a fusion mode and a longitudinal bisection mode;

The two-dimensional registration module further comprises a functional module, wherein the functional module comprises a reset position functional module, a first split-screen display near-end functional module, a first split-screen display far-end functional module, a transparency functional module and an image fusion functional module;

The two three-dimensional registration modules further comprise a registration module, and registered images are obtained by adjusting the positions of the two-dimensional images and the three-dimensional images;

the system also comprises a tool calibration module for calibrating the tool;

The tool comprises a sleeve and an intramedullary nail;

The system further includes a path guidance module for bone opening, implantation of an intramedullary nail based on a path in the path guidance module;

the path guiding module comprises a path list module for displaying the information of the planned path;

the path list module comprises an automatic path selecting module for automatically switching the guide path;

The path guiding module further comprises a navigation tool module for displaying navigation information;

The navigation tool module comprises a navigation tool transparency module and an extension line module;

The path guiding module further comprises a model transparency module for setting transparency of the three-dimensional model;

the path guiding module further comprises a path guiding prompt information module used for displaying the path distance, the target distance and the angle.

8. A computer program product comprising computer program/instructions, characterized in that the computer program/instructions is executed by a processor to perform a method of planning a fracture reduction path according to any one of claims 1-3 or to perform a method of planning an intramedullary nail installation path according to any one of claims 4-5.

9. A computer device comprising a memory, a processor, and a computer program stored on the memory, comprising:

The processor performs a method of planning a fracture reduction path implementing the computer program as claimed in any one of claims 1 to 3 or a method of planning an intramedullary nail installation path implementing any one of claims 4 to 5.

10. A computer readable storage medium having stored thereon a computer program/instructions, which when executed by a processor, performs the method of planning a fracture reduction path according to any one of claims 1-3 or performs the method of planning an intramedullary nail installation path according to any one of claims 4-5.