Friday, 14 December 2018

Distal targeting for intramedullary nail


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Thierry LELOUP - Frédéric SCHUIND - Wissam EL KAZZI - Nadine WARZEE

Project description

During intra-medullary nailing, the distal locking is one of the most difficult steps. Numerous methods have been developed to help the surgeon but all are time-consuming and impose much irradiation. We have developed and tested a method based only on two fluoroscopic shots that do not require to be taken in the axes of the holes.


A 3D model of the nail distal part and of its locking holes is built thanks to a pair of calibrated fluoroscopic views. A 3D optical localizer is used to track reference frames fixed to the nail, the imaging device and the drilling motor. This model was used in a navigation system to guide the surgeon during distal targeting.


The precision and the duration of this technique are fully compatible with clinical use.

Nail3.jpg Nail4.jpg

Related publications

  • T. Leloup, W. El Kazzi, O. Debeir, F. Schuind, N. Warzée, Automatic fluoroscopic Image Calibration for Traumatology Intervention Guidance, Proceedings of the IEEE EUROCON International Conference, Belgrade, Serbia & Montenegro, pp 374-377, 2005.
  • Leloup Th., El Kazzi W., Schuind F., Warzée N., Distal locking of intra-medullary nail using non-constrained fluoroscopic images, Surgetica’2005 – Computer-Aided Medical Interventions : tools and applications, Grenoble, France, pp 287-293, 2005.
  • Leloup Th., El Kazzi W., Schuind F., Warzée N., Traumatology surgical intervention guided by virtual reality, Proceedings of the 6th IEEE Virtual Reality International Conference, Laval, France, pp 53-59, 2004.


  • Thierry Leloup, Frédéric Schuind, Nadine Warzée, Process for the acquisition of information intended for the insertion of a locking screw into an orifice of an endomedullary device (EP1491151A1 and US2005027304A1)