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Updated: Feb 12, 2026

Treatment with Locking Intramedullary Nailing for Intertrochanteric Fracture of the Femur Utilizing a New Awl with a Distal Positioner
Published on: June 6, 2025
Three-dimensional augmented reality surgical navigation with hybrid optical and electromagnetic tracking for distal
Longfei Ma1, Zhe Zhao2, Boyu Zhang1
1Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China.
Background:
Intramedullary nail (IMN) fixation improves functional outcomes for the diaphyseal fractures of long bones. However, locking the distal holes of the IMN is challenging. Although several navigation methods have been proposed, an intuitive, radiation-free and accurate navigation method that does not suffer from problems of hand-eye coordination has not yet been described.
Methods:
This paper proposes an augmented reality (AR) surgical navigation method with hybrid optical and electromagnetic (EM) tracking for distal IMN interlocking. Model experiments are designed to evaluate the AR-guided distal interlocking method.
Results:
AR-guided drilling procedures were performed on 5 tibia models and a leg phantom. The accuracy (hit or miss) was evaluated using fluoroscopy. The experimental results demonstrated that all 18 drills successfully hit the distal holes at a rate of 100%.
Conclusions:
Our results indicate that the AR-guided distal interlocking method is feasible and has many potential applications in clinic after further evaluation.
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