Method and arrangement for determining where to position fixation means

• US 6,567,681 B1
• Filed: 11/13/2000
• Issued: 05/20/2003
• Est. Priority Date: 04/01/1998
• Status: Expired due to Fees

• Current Assignee: Medical Robotics I Stockholm AB
• Original Assignee: Medical Robotics I Stockholm AB
• Inventors: Lindequist, Stig
• Primary Examiner(s): NERBUN, PETER P
• Application Number:
  US09/647,451
• Time in Patent Office: 918 Days
• Field of Search: 600/407, 600/427, 606/96, 606/97, 606/130, 378/20, 378/205
• US Class Current: 600/407
• CPC Class Codes: A61B 17/1703 using imaging means, e.g. by X-rays
• CPC Class Codes: A61B 17/1721 for applying pins along or parallel to the axis of the femoral neck
• CPC Class Codes: A61B 6/02 Arrangements for diagnosis sequentially in different planes; Stereoscopic radiation diagnosis
• CPC Class Codes: A61B 6/12 Arrangements for detecting or locating foreign bodies

Abstract

The present invention is comprised of a method for determining, in three dimensions, where to position fixating means (32) in a hip bone fracture structure (30) by pre-surgery analysis of at least one anteroposterior and one lateral digitized radiograph of a fracture. The method is applied to control an arrangement (40) with a tool for drilling in the correct direction in order to accomplish a best possible healing of a fractured hip bone structure (30).

Claims

1. A method for determining, in three dimensions, where to position a fixating device in a hip fracture structure by pre-surgery analysis of at least one anteroposterior and one lateral digitized radiograph of said fracture, said method comprising:

determining a construed femoral shaft axis out of said graphs from at least two midpoints on said shaft axis and drawing a line through said midpoints;

determining a construed femoral neck axis from at least two midpoints on said neck axis and drawing a line through said midpoints;

determining femoral neck angles (α

, β

);

determining a femoral head diameter out of said graphs by placing a circle over the perimeter of the femoral head;

scaling and rotating said radiographs to a predefined size and position, using an angle between the femoral shaft and a Y-axis in said digitized radiographs, and said diameter of the femoral head;

determining a femoral neck diameter out of said radiographs by drawing a line, perpendicular to the femoral neck axis, at the intersection of the femoral head sphere and the central femoral neck axis;

determining the distance from said neck axis and the center of said femoral head perpendicular to the femoral neck axis, representing a remaining displacement of the hip fracture which is implicitly known from said head diameter;

measuring the height of the medial cortex out of the anteroposterior graph;

displaying said femoral neck angles (α

, β

);

displaying cross-sections of the femoral head and femoral neck with a predetermined degree of accuracy;

rotating said cross-sections of the femoral head and femoral neck in order to determine a degree of derotation of the hip, imposed by the fracture;

displaying the degree of hip rotation in said anteroposterior and lateral radiographs; and

using said steps in order to determine a position, in three dimensions, for attachment of said fixating device.

2. A method according to claim 1, wherein the femoral neck angles (α

, β

) are displayed as lines and numerical values in said digitized graphs, said lines are automatically re-drawn if a value is changed.

3. A method according to claim 1, wherein symbols for said fixating device are placed within the cross-section of the femoral neck.

4. A method according to claim 3, wherein a warning function is activated if said fixating device is placed outside the femoral head or femoral neck in said digitized radiographs.

5. A method according to claim 3, wherein the fixating device for attachment is automatically displayed in said graphs with relation to previously made measurements.

6. A method according to claim 1, wherein a device is provided for putting down symbols for fixating means in said digitized radio graphs.

7. A method, according to claim 2, wherein said lines are regression lines drawn from at least three midpoints.

8. An arrangement providing for attachment of a fixating means in a hip fracture structure, through analyzing at least one anteroposterior and one lateral digitized radiograph of said fracture, comprising:

measurement means for determining a femoral shaft axis out of said graphs from at least two midpoints on said shaft axis, and drawing a line through said midpoints;

measurement means for determining a femoral neck axis from at least two midpoints on said neck axis and drawing a line through said midpoints;

measurement means for determining femoral neck angles (α

, β

);

measurement means for determining a femoral head diameter out of said graphs by placing a circle over the perimeter of said femoral head;

measurement means determining a femoral neck diameter out of said radiographs by drawing a line, perpendicular to the femoral-neck axis, at the intersection of the femoral head sphere and the central femoral neck axis;

driver means for scaling and rotating said radiographs to a predefined size and position, using an angle between the femoral shaft and a Y-axis in said digitized radiographs, and said femoral head diameter;

measurement means for determining the distance from the femoral-neck axis to the center of said femoral head perpendicular to the femoral neck axis, representing a remaining displacement of the fracture, which is implicitly known from said femoral head diameter;

measurement means for determining the height of the medial cortex out of said anteroposterior graph;

display means for displaying said neck angles (α

, β

);

display means for providing displays of cross-sections of said femoral head and femoral neck with a predetermined degree of accuracy,

driver means for rotating said cross-sections of the femoral head and femoral neck in order to determine a degree of hip derotation (Ω

) between said femoral head and femoral neck, imposed by the fracture, and

display means for displaying said hip rotation in said anteroposterior and lateral radiographs, said display means providing control input to a robot with tool means on said robot for working in a direction given by said control input, and distortion correcting means compensating for x-ray distortion.

9. An arrangement according to claim 8, wherein the femoral neck angles (α

, β

) are displayed, by said display means for displaying said neck angles, as lines and numerical values in said digitized graphs, said lines are automatically re-drawn if a value is changed.

10. An arrangement according to claim 8, wherein symbols for said fixating means are placed within the cross-section of the femoral neck and displayed by said means for displaying.

11. An arrangement according to claim 10, wherein a warning function is activated if said fixating means is placed outside said femoral head or femoral neck in the digitized radiographs.

12. An arrangement according to claim 10, wherein said fixating means for attachment is automatically displayed in said graphs with relation to previously made measurements.

13. An arrangement according to claim 8, wherein means are provided for putting down symbols for fixating means in said digitized radiographs.

14. An arrangement according to claim 9, wherein said lines are regression lines drawn from at least three midpoints.

15. An arrangement providing for attachment of a fixation device in a hip fracture structure, through analyzing at least one anteroposterior and one lateral digitized radiograph of said fracture, comprising:

a measurement device to determine a femoral shaft axis out of said graphs from at least two midpoints on said shaft axis, and drawing a line through said midpoints;

a measurement device to determine a femoral neck axis from at least two midpoints on said neck axis and drawing a line through said midpoints;

a measurement device to determine femoral neck angles (α

, β

);

a measurement device to determine a femoral head diameter out of said graphs by placing a circle over the perimeter of said femoral head;

a measurement device to determine a femoral neck diameter out of said radiographs by drawing a line, perpendicular to the femoral-neck axis, at the intersection of the femoral head sphere and the central femoral neck axis;

a driver device to scale and rotate said radiographs to a predefined size and position, using an angle between the femoral shaft and a Y-axis in said digitized radiographs, and said femoral head diameter;

a measurement device to determine the distance from the femoral neck axis to the center of said femoral head perpendicular to the femoral neck axis, representing a remaining displacement of the fracture, which is implicitly known from said femoral head diameter;

a measurement device to determine the height of the medial cortex out of said anteroposterior graph;

a display to display said neck angles (α

, β

);

a display to provide displays of cross-sections of said femoral head and femoral neck with a predetermined degree of accuracy,

a driver device to rotate said cross-sections of the femoral head and femoral neck in order to determine a degree of hip derotation (Ω

) between said femoral head and femoral neck, imposed by the fracture,

a display to display said hip rotation in said anteroposterior and lateral radiographs, said display provides control input to a robot with a tool on said robot for working in a direction given by said control input, and a distortion correcting device for compensating for x-ray distortion.

16. An arrangement according to claim 15, wherein femoral neck angles (α

, β

) are displayed as lines and numerical values in said digitized graphs, said lines are automatically re-drawn if a value is changed.

17. An arrangement according to claim 15, wherein symbols for said fixation device are placed within the cross-section of the femoral neck and displayed by said display.

18. An arrangement according to claim 17, wherein a warning function is activated if said fixation device is placed outside said femoral head or femoral neck in the digitized radiographs.

19. An arrangement according to claim 17, wherein said fixation device is automatically displayed in said graphs with relation to previously made measurements.

20. An arrangement according to claim 15, wherein a device is provided for putting down symbols for said fixation device in said digitized radiographs.

21. An arrangement according to claim 16, wherein said lines are regression lines drawn from at least three midpoints.