PURPOSE Minimally invasive surgery is widely used for managing fractures; however, it is difficult to determine the exact screwing position of intramedullary nails inserted into bone. To address this problem, we developed the aiming and targeting system by laser (ATLAS) using two line lasers to mark the position of the surgical tool directly on the skin. METHODS ATLAS consists of a laser module, controller, personal computer, and display device. The laser module is fixed to the intensifier side of the C-arm. Calibration with dedicated markers is required prior to using the system. After calibration, the laser modules can mark the selected point on a fluoroscopic image acquired with the C-arm as the intersection of the two line lasers on the skin. RESULTS To verify the effectiveness of ATLAS, marking accuracy was measured. The average control error of the device itself was 0.57 mm. In the experimental setting using C-arm fluoroscopy, the accuracy was within 1.5 mm at 23 of the 25 measurement points and within 3 mm at the remaining two points. CONCLUSION ATLAS shows the corresponding points in real space with respect to fluoroscopic images using cross-points of lasers. The proposed method is clinically useful to aid the insertion of interlocking screws in minimally invasive surgeries for bone fractures. We believe that ATLAS enables more accurate marking through C-arm fluoroscopy and is more convenient, and it can thus be applied in various orthopedic surgeries.

中文翻译：

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基于荧光图像的瞄准和瞄准系统，带有两行激光，用于互锁螺钉的插入引导。

目的微创手术被广泛用于骨折的治疗。然而，很难确定插入骨中的髓内钉的确切拧紧位置。为了解决这个问题，我们开发了使用两线激光通过激光（ATLAS）进行瞄准和瞄准的系统，以在皮肤上直接标记手术工具的位置。方法ATLAS由激光模块，控制器，个人计算机和显示设备组成。激光模块固定在C型臂的增强侧。在使用系统之前，需要使用专用标记物进行校准。校准后，激光模块可以在用C臂获取的透视图像上标记选定的点，将其作为皮肤上两行激光的交点。结果为了验证ATLAS的有效性，对标记准确性进行了测量。设备本身的平均控制误差为0.57 mm。在使用C型臂透视的实验环境中，在25个测量点中的23个测量点的精度在1.5毫米以内，在其余两个点的精度在3毫米以内。结论ATLAS使用激光的交叉点显示了在透视图像中真实空间中的对应点。所提出的方法在临床上有助于在骨折的微创手术中帮助插入互锁螺钉。我们相信，ATLAS可以通过C型臂荧光透视术进行更准确的标记，并且更加方便，因此可以应用于各种骨科手术。结论ATLAS使用激光的交叉点显示了在透视图像中真实空间中的对应点。所提出的方法在临床上有助于在骨折的微创手术中帮助插入互锁螺钉。我们相信，ATLAS可以通过C型臂荧光透视术进行更准确的标记，并且更加方便，因此可以应用于各种骨科手术。结论ATLAS使用激光的交叉点显示了在透视图像中真实空间中的对应点。所提出的方法在临床上有助于在骨折的微创手术中帮助插入互锁螺钉。我们相信，ATLAS可以通过C型臂荧光透视术进行更准确的标记，并且更加方便，因此可以应用于各种骨科手术。