Abstract
Purpose: Quantify the precision and accuracy in coordinate measurements of anatomic landmarks of the femur using spatially tracked ultrasound (US) images. Establish the limits on coordinate measurement errors required for accurate determination of bone fragment alignment during intramedullary (IM) nail fixation of femoral shaft fractures. Relevance: A surgical guidance system based on a three-dimensional (3D) representation of femoral anatomy from US images would eliminate the hazard of radiation exposure and potentially increase the accuracy of IM nailing procedures. Summary: Fiducial spheres (dia. 6.3mm) were embedded in a plastic femur to mark anatomic landmarks. The femur was suspended in a water tank and could be rotated about its long axis. An US probe was mounted to a track above the femur. Images were collected at 5mm increments along the anterior, posterior, lateral and medial aspects. After the US experiment, fiducial centroid locations (x,y,z-coordinates) were measured in a coordinate measuring machine (CCM). Reconstructed fiducial positions from US images were compared to the CMM data to assess precision and accuracy. A numerical model relating errors in landmark coordinate measurements to rigid body alignment was implemented. The mean precision (std-dev.) in fiducial coordinate measurements was 1.69mm. Mean and maximum errors in fiducial positions were 17.65mm and 58.01mm, respectively. At the observed level of accuracy in coordinate measurements, the model predicted rigid body rotation errors of 3.4 (SD = 2.4)° and translation errors of 4.7 (SD = 3.2)mm. A proof-of-concept has been demonstrated in the use of clinical US to obtain a quantitative description of femoral anatomy in a 3D framework. The model of error limits provided a basis for assessing the capability of a tracked US system in the context of a clinical criterion for rotational alignment (anteversion angle). Accuracy requirements for landmark coordinate measurements were at the limits of the capability of the current US tracking system.
Chapter PDF
Similar content being viewed by others
Keywords
- Coordinate Measuring Machine
- Fiducial Marker
- Femoral Shaft Fracture
- Femoral Anteversion
- Clinical Ultrasound
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
References
Mooney, V., Claudi, B.F.: Fractures of the shaft of the femur. In: Rockwood, C.A., Green, D.P. (eds.) Fractures in Adults., pp. 1396–1398. J.B. Lippincott Company, Philidelphia (1984)
Lausten, G.S., Jorgeson, F., Boesen, J.: Measurement of anteversion of the femoral neck: ultrasound and computerised tomography compared. J. Bone Joint Surg. 75-B, 799–803 (1989)
Braten, M., Terjesen, T., Rossvoll, I.: Torsional deformity after intramedullary nailing of femoral shaft fractures: Measurement of anteversion angles in 110 patients. J. Bone Joint Surg. (Br) 75(5), 7990–8003 (1993)
Levin, P.E., Schoen, R.W., Browner, B.D.: Radiation exposure to the surgeon during closed interlocking intramedullary nailing. J. Bone and Joint Surg. (Am) 69(5), 761–766 (1987)
Coetzee, J.C., van der Merwe, E.J.: Exposure of surgeons-in-training to radiation during intramedullary fixation of femoral shaft fractures. S. Afr. Med. J. 81(6), 312–314 (1992)
Muller, L.P., Suffner, J., Wenda, K., Mohr, W., Rommens, P.M.: Radiation exposure to the hands and the thyroid of the surgeon during intramedullary nailing. Injury 29(6), 461–468 (1998)
Smith, G.L., Wakeman, R., Briggs, T.W.: Radiation exposure of orthopaedic trainees: quantifying the risk. J. Royal College Surg. 41(2), 132–134 (1996)
Vannier, M.W., Marsh, J.L.: Three-dimensional imaging, surgical planning, and image-guided therapy. Radiol. Clin. North. Am. 34(3), 545–563 (1996)
Glossop, N., Hu, R.: Effect of registration method on clinical accuracy of image guided pedicle screw surgery. In: Computer Assisted Radiology and Surgery, Proceedings of the 11th International Symposium and Exhibition, Berlin, Germany, pp. 884–888 (1997)
Hu, R., Glossop, N., Steven, D., Randle, J.: Accuracy of image guided placement of iliosacral lag screws. In: Troccaz, J., Mösges, R., Grimson, W.E.L. (eds.) CVRMed-MRCAS 1997, LNCS, vol. 1205, pp. 593–596. Springer, Heidelberg (1997)
Joskowicz, L., Milgrom, C., Simkin, A., Tockus, L., Yaniv, Z.: FRACAS: a system for computer-aided image-guided long bone fracture surgery. Comput. Aided Surg. 3(6), 271–288 (1998)
Hata, N., Dohi, T., Iseki, H., Takakura, K.: Development of a frameless and armless stereotactic neuronavigation system with ultrasonographic registration. Neurosurgery 41(3), 608–613 (1997)
Schreiner, S., Galloway, R.L., Lewis, J.T., Bass, W.A., Muratore, D.M.: An ultrasonic approach to localization of fiducial markers for interactive, image-guided neurosurgery - Part II: Implementation and automation. IEEE Transactions on Biomedical Engineering 45(5), 631–641 (1998)
Mahaisavariya, B., Laupattarakasem, W.: Ultrasound or image intensifier for closed femoral nailing. J. Bone Joint Surg (Br) 75(1), 66–68 (1993)
Soederqvist, I., Wedin, P.A.: Determining the movement of the skeleton using well-configured markers. J. Biomech. 26, 1473–1477 (1993)
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2000 Springer-Verlag Berlin Heidelberg
About this paper
Cite this paper
Young, D.I., Staniforth, S.M., Hu, R.W. (2000). Three-Dimensional Measurement of the Femur Using Clinical Ultrasound: Developing a Basis for Image Guided Intramedullary Nail Fixation of the Femur. In: Delp, S.L., DiGoia, A.M., Jaramaz, B. (eds) Medical Image Computing and Computer-Assisted Intervention – MICCAI 2000. MICCAI 2000. Lecture Notes in Computer Science, vol 1935. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-40899-4_131
Download citation
DOI: https://doi.org/10.1007/978-3-540-40899-4_131
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-540-41189-5
Online ISBN: 978-3-540-40899-4
eBook Packages: Springer Book Archive