Development of computer-assisted technology for the wrist surgery

We have conducted several technological advancements to enhance the efficiency of computer-assisted technologies in the wrist surgery. In this presentation, the key technologies developed for computer-assisted wrist surgery are presented and their future prospects are discussed. 

1. Registration of fluoroscopic images and CT volumes using a 3D reconstruction network 
   
   Based on the 3D data of CT images obtained preoperatively, we established a method for marker-less registration of X-ray fluoroscopic images and CT models. We built a fully automatic registration pipeline that aligns the 3D shape reconstructed from X-ray images with the preoperative 3D-CT model. We validated the registration accuracy of the developed algorithm. It could estimate the position and orientation of the 3D model corresponding to the X-ray images more accurately than conventional algorithms. 
    
2. Development of Augmented Reality (AR) technology using a 3D camera 
   
   We developed an AR-based system to visualize bone structures in the surgical field. Using a 3D camera, we captured the forearm model’s shape and position and projected a CT-derived 3D bone model onto the surgical field. Position estimation accuracy was evaluated, revealing an average error of 1.4±0.6 mm, confirming the system’s potential for precise intraoperative guidance. 
    
3. Virtual Reality (VR) Preoperative Planning for Distal Radius Fractures 
   
   We developed a VR surgical planning method for distal radius fracture osteosynthesis using game development software. We created a 3D model of the fracture site from preoperative CT data. The 3D data of the fracture site and implant were imported into the VR environment, adjusted physical calculations and model representation settings between models, and performed preoperative planning. For accuracy evaluation, we compared the implant placement position in the VR plan with the 3D reconstruction image of the postoperative CT. We found that it was possible to predict the reduction position and plate placement position in virtual space.