Simulation of patient specific cervical hip fracture surgery with a volume haptic interface.

The interest for surgery simulator systems with anatomical models generated from authentic patient data is growing as these systems evolve. With access to volumetric patient data, e.g., from a computer tomography scan, haptic and visual feedback can be created directly from this dataset. This opens the door for patient specific simulations. Hip fracture surgery is one area where simulator systems is useful to train new surgeons and plan operations. To simulate the drilling procedure in this type of surgery, a repositioning of the fractured bone into correct position is first needed. This requires a segmentation process in which the bone segments are identified and the position of the dislocated part is determined. The segmentation must be automatic to cope with the large amount of data from the computer tomography scan. This work presents the first steps in the development of a hip fracture surgery simulation with patient specific models. Visual and haptic feedback is generated from the computer tomography data by simulating fluoroscopic images and the drilling process. We also present an automatic segmentation method to identify the fractured bone and determine the dislocation. This segmentation method is based on nonrigid registration with the Morphon method.