Significance: Extremity injury represents the leading cause of trauma hospitalizations among adults under the age of 65 years, and long-term impairments are often substantial. Restoring function depends, in large part, on bone and soft tissue healing. Thus, decisions around treatment strategy are based on assessment of the healing potential of injured bone and/or soft tissue. However, at the present, this assessment is based on subjective clinical clues and/or cadaveric studies without any objective measure. Optical imaging is an ideal method to solve several of these issues. Aim: The aim is to highlight the current challenges in assessing bone and tissue perfusion/viability and the potentially high impact applications for optical imaging in orthopaedic surgery. Approach: The prospective will review the current challenges faced by the orthopaedic surgeon and briefly discuss optical imaging tools that have been published. With this in mind, it will suggest key research areas that could be evolved to help make surgical assessments more objective and quantitative. Results: Orthopaedic surgical procedures should benefit from incorporation of methods to measure functional blood perfusion or tissue metabolism. The types of measurements though can vary in the depth of tissue sampled, with some being quite superficial and others sensing several millimeters into the tissue. Most of these intrasurgical imaging tools represent an ideal way to improve surgical treatment of orthopaedic injuries due to their inherent point-of-care use and their compatibility with real-time management. Conclusion: While there are several optical measurements to directly measure bone function, the choice of tools can determine also the signal strength and depth of sampling. For orthopaedic surgery, real-time data regarding bone and tissue perfusion should lead to more effective patient-specific management of common orthopaedic conditions, requiring deeper penetrance commonly seen with indocyanine green imaging. This will lower morbidity and result in decreased variability associated with how these conditions are managed.

中文翻译：

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用于肌肉骨骼四肢创伤手术功能评估的光学成像前景。

意义：四肢损伤是 65 岁以下成年人外伤住院的主要原因，而且长期损伤通常很严重。恢复功能在很大程度上取决于骨骼和软组织的愈合。因此，围绕治疗策略的决定是基于对受伤骨骼和/或软组织的愈合潜力的评估。然而，目前，这种评估是基于主观的临床线索和/或尸体研究，没有任何客观的衡量标准。光学成像是解决其中几个问题的理想方法。目的：目的是强调当前评估骨骼和组织灌注/活力的挑战，以及光学成像在骨科手术中的潜在高影响应用。方法：预期将回顾整形外科医生目前面临的挑战，并简要讨论已发表的光学成像工具。考虑到这一点，它将建议可以发展的关键研究领域，以帮助使手术评估更加客观和定量。结果：骨科手术应该受益于结合测量功能性血液灌注或组织代谢的方法。但是，测量的类型可能会因采样的组织深度而异，有些是非常肤浅的，有些则可以感应到组织内几毫米的深度。大多数这些手术内成像工具代表了改善骨科损伤手术治疗的理想方式，因为它们具有固有的即时使用和与实时管理的兼容性。结论：虽然有几种光学测量可以直接测量骨骼功能，但工具的选择也可以确定信号强度和采样深度。对于骨科手术，有关骨和组织灌注的实时数据应该能够对常见骨科疾病进行更有效的针对患者的管理，这需要更深的外显率，这在吲哚菁绿成像中很常见。这将降低发病率并导致与如何管理这些条件相关的可变性降低。需要更深的外显率，通常见于吲哚菁绿成像。这将降低发病率并导致与如何管理这些条件相关的可变性降低。需要更深的外显率，通常见于吲哚菁绿成像。这将降低发病率并导致与如何管理这些条件相关的可变性降低。