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In unilateral pelvic fracture reductions, surgeons attempt to reconstruct thebone fragments such that bilateral symmetry in the bony anatomy is restored. Wepropose to exploit this "structurally symmetric" nature of the pelvic bone, andprovide intra-operative image augmentation to assist the surgeon in repairingdislocated fragments. The main challenge is to automatically estimate thedesired plane of symmetry within the patient's pre-operative CT. We propose toestimate this plane using a non-linear optimization strategy, by minimizingTukey's biweight robust estimator, relying on the partial symmetry of theanatomy. Moreover, a regularization term is designed to enforce the similarityof bone density histograms on both sides of this plane, relying on thebiological fact that, even if injured, the dislocated bone segments remainwithin the body. The experimental results demonstrate the performance of theproposed method in estimating this "plane of partial symmetry" using CT imagesof both healthy and injured anatomy. Examples of unilateral pelvic fracturesare used to show how intra-operative X-ray images could be augmented with theforward-projections of the mirrored anatomy, acting as objective road-map forfracture reduction procedures.

Exploiting Partial Structural Symmetry For Patient-Specific Image Augmentation in Trauma Interventions