Electromagnetic/magnetic-coupled targeting system for screw-hole locating in intramedullary interlocking-nail surgery

At present, intramedullary interlocking nails are widely used for bone-fracture fixation in orthopedic surgeries. Surgeons often use X-ray imaging to find the actual location of the distal screw-holes of the nail after the nail is inserted into the medullary canal of a bone for fixation. Thus, the patients and medical team are inevitably exposed to radioactivity. In this paper, we report a radiation-free electromagnetic/magnetic-coupled targeting system to locate the distal screw-holes of the nail used in interlocking-nail surgery. The targeting system consists of a c-shaped electromagnet with a pick-up coil, a highly permeable curved silicon-steel strip embedded on the nail, a guiding mechanism, and electronic measuring instruments. An alternative current is applied to the electromagnet to generate a uniform magnetic field/flux in the electromagnet's air gap. When the nail inserted into the medullary canal of a bone is scanned through or rotated in the air gap of the electromagnet, the magnetic flux in the air gap is influenced by the silicon-steel strip embedded on the nail. The variation of the magnetic flux induces a voltage response in the pick-up coil due to electromagnetic induction. The pattern of the voltage response is analyzed to establish a criterion for screw-hole targeting. The results obtained using this criterion reveal that the maximum targeting error of the location and orientation targeting for a screw-hole with a diameter of 5 mm is <2 mm and 10°, respectively. Thus, the system/approach is sufficiently simple and accurate to be used by surgeons in clinical surgery.