Image-guided fracture reduction

Abstract

Embodiments of the present invention include products and methods for reducing fractures with the aid of image guidance. In one embodiment, products and methods are directed to reduction for the placement of an intramedullary nail.

1 - 43 . (canceled)  
   
   
       44 . A method of enabling reduction of a fractured bone by virtually representing at least one fractured segment of the bone and virtually representing an at least partially flexible instrument for aligning two or more segments comprising: 
 recording a position and orientation of a first segment of the bone;    tracking the position and orientation of the first segment;    recording a position and orientation of one or more location elements on the at least    partially flexible instrument for aligning the segments;    tracking the position and orientation of the at least partially flexible instrument; and    indicating through a virtual representation to a user that alignment has been achieved such that the instrument may be engaged with the first segment and a second segment.    
   
   
       45 . The method of  claim 44 , wherein the recording a position and orientation of the first segment comprises storing data in a computer, the data numerically representing a three-dimensional position and orientation of the first segment.  
   
   
       46 . The method of  claim 45 , wherein the. tracking the first segment comprises calculating changes to the data responsive to changes in the position and orientation of the first segment.  
   
   
       47 . The method of  claim 44 , wherein the recording a position and orientation of the at least partially flexible instrument for aligning the segments comprises storing data in a computer, the data numerically representing a three-dimensional position and orientation of the at least partially flexible instrument.  
   
   
       48 . The method of  claim 47 , wherein the tracking the at least partially flexible instrument for aligning the segments comprises calculating changes to the data responsive to changes in the position and orientation of the at least partially flexible instrument for aligning the segments.  
   
   
       49 . The method of  claim 44 , wherein the indicating that alignment has been achieved comprises indicating that the first segment and the at least partially flexible instrument are aligned.  
   
   
       50 . The method of  claim 44 , further comprising: 
 recording a position and orientation of a second segment of the bone.    
   
   
       51 . The method of  claim 50 , further comprising: 
 tracking the position and orientation of the second segment.    
   
   
       52 . The method of  claim 51 , wherein the indicating that alignment has been achieved comprises indicating that the first segment, the second segment, and the at least partially flexible instrument are aligned.  
   
   
       53 . The method of  claim 51 , wherein the act of indicating that alignment has been achieved comprises indicating that the first segment and the second segment are aligned.  
   
   
       54 - 57 . (canceled)  
   
   
       58 . The method of claim  56 , further comprising: 
 applying a force to the at least partially flexible reducer in order to impart at least partial rigidity to the reducer.    
   
   
       59 . (canceled)  
   
   
       60 . An instrument operable with an image-guided surgical navigation system for aligning fractured segments of a bone comprising: 
 an elongated body, having an at least partially flexible portion; A    a reference coupled to the elongated body for enabling the instrument to be located by the image-guided surgical navigation system; and    one or more location elements on the at least partially flexible portion;    wherein the reference has a predefined physical relationship with the elongated body such that by observing the position and orientation of the reference relative to one or more of the fractured segments, the position and orientation of the elongated body relative to one or more of the fractured segments can be determined and wherein the position and orientation of the at least partially flexible portion can be determined by observing the position and orientation of the location elements.    
   
   
       61 . The instrument of  claim 60 , wherein the elongated body is tubular.  
   
   
       62 . The instrument of  claim 60 , wherein the elongated body is solid.  
   
   
       63 . The instrument of  claim 60 , wherein the elongated body is greater than half the greatest length of the fractured bone.  
   
   
       64 . The instrument of  claim 60 , wherein the elongated body is less than or equal to half the greatest length of the fractured bone.  
   
   
       65 . The instrument of  claim 60 , wherein the elongated body is substantially straight.  
   
   
       66 . The instrument of  claim 60 , wherein the elongated body is curved.  
   
   
       67 . The instrument of  claim 60 , wherein the elongated body is substantially the same curvature as an implant to be used to fix the bone segments in place.  
   
   
       68 . The instrument of  claim 60 , wherein the reference comprises an energy-reflecting surface wherein the reflected energy is detected by a sensor.  
   
   
       69 . The instrument of  claim 60 , wherein the reference comprises an energy-emitting component that wherein the energy is detected by a sensor.  
   
   
       70 . The instrument of  claim 60 , wherein the reference is removably coupled to the elongated body.  
   
   
       71 . The instrument of  claim 60 , wherein the reference is symmetrically coupled to the elongated body such that the instrument can be effectively used on either side of a patient.  
   
   
       72 . The instrument of  claim 60 , wherein the reference is asymmetrically coupled to the elongated body such that the instrument is more effectively useable on one side of a patient.  
   
   
       73 . The instrument of  claim 60 , wherein the reference is releasably movable relative to the elongated body such that the instrument can be effectively used on either side of a patient by moving the reference among two or more predetermined positions.  
   
   
       74 . The instrument of  claim 60 , wherein the reference is releasably movable between positions located at ninety degree intervals around the elongated body  
   
   
       75 . The instrument of  claim 60 , further comprising a handle coupled to one end of the elongated body.  
   
   
       76 . The instrument of  claim 60 , further comprising a curved tip.  
   
   
       77 - 78 . (canceled)  
   
   
       79 . The instrument of  claim 60 , wherein the one or more location elements can be sensed in location actively or passively.  
   
   
       80 . The instrument of  claim 60 , wherein the one or more location elements can be sensed in location using one or more of the following techniques: infrared, visual, reflective, sound, ultrasound, radio wave, mechanical wave, magnetic, electromagnetic, electrical, x-ray, GPS systems or chips, transponder, or transducer.  
   
   
       81 . The instrument of  claim 60 , wherein the at least partially flexible elongated-by portion comprises a feature that imparts at least partial rigidity to the reducer.  
   
   
       82 . A system for enabling reduction of a fractured bone operable to virtually represent at least one fractured segment of the bone and virtually represent an at least partially flexible instrument for aligning the at least one fractured segment, the at least partially flexible instrument including one or more location elements, comprising: 
 a first reference coupled to the at least on fractured segment;    a second reference coupled to the at least partially flexible instrument;    a detector operable to collect position and orientation information regarding the at least one fractured segment and the at least partially flexible instrument;    a data processing device operable to store position and orientation information about the at least one fractured segment and the at least partially flexible instrument, and to calculate virtual positions of the at least one fractured segment and the at least partially flexible instrument based upon inputs from the detector; and    an indicator device for notifying a user of the relative positions of the at least one fractured segment and the at least partially flexible instrument.