Department of Mechanical Engineering2024-12-2920231017-995X10.5152/j.aott.2023.221752-s2.0-85169759101https://doi.org/10.5152/j.aott.2023.22175https://hdl.handle.net/20.500.14288/23411Objective: This study aimed to introduce a method to extract the 3-dimensional spatial position of the femoral head implant from 2-dimensional fluoroscopic projections, allowing surgeons to assess fixation much more accurately and prevent cut-out complications in proximal femoral nailing. Methods: To define a safety region for the tip in the femoral head, a novel 3-dimensional distance-based risk parameter called TSD3D was introduced. An intersection algorithm was developed that solely takes the fluoroscopic anteroposterior and lateral distances to reveal the 3-dimensional location of the screw or Kirschner wire tip, enabling the utilization of the 3-dimensional parameter. Orthogonal perspectives of 6 femur proximal bone substitutes with randomly inserted Kirschner wires were imaged under fluoroscopy. The developed algorithm was used to calculate the implant tip location in 3-dimensional from 2-dimensional images for each case. Algorithm accuracy was validated with the computed tomography-obtained 3-dimensional models of the same femur substitutes. Results: The newly introduced risk parameter successfully visualizes 3-dimensional safety regions. Utilizing the 2-dimensional fluoroscopic distances as inputs to the algorithm, the 3-dimensional position of the implanted Kirschner wire tip is calculated with a maximum of 9.8% error for a single Cartesian-coordinate measurement comparison. Conclusion: By incorporating the newly introduced 3-dimensional risk parameter, surgeons can more precisely evaluate the position of the implant and avoid cut-out complications, instead of relying solely on misleading 2-dimensional fluoroscopic projections of the femoral head.OrthopedicsJournal article1104870600002Q341554