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CTRI Number  CTRI/2026/01/100865 [Registered on: 12/01/2026] Trial Registered Prospectively
Last Modified On: 09/06/2026
Post Graduate Thesis  No 
Type of Trial  Observational 
Type of Study   Follow Up Study 
Study Design  Other 
Public Title of Study   AI-Based Medical Image Analysis Software using X-ray Imaging. 
Scientific Title of Study   An ambispective, multi-center, observational study to develop and validate AI Model to assist orthopaedic surgeons in the precise selection of sizes of nails, screws, and implants. 
Trial Acronym  NIL 
Secondary IDs if Any  
Secondary ID  Identifier 
NIL  NIL 
 
Details of Principal Investigator or overall Trial Coordinator (multi-center study)  
Name  Dr Bhaumik Dave 
Designation  General Manager 
Affiliation  Nuvo AI Pvt. Ltd 
Address  135/139 Bilakhia House Muktanand Marg Chala Vapi Pardi Valsad 396191 Gujarat

Valsad
GUJARAT
396191
India 
Phone  9978232094  
Fax    
Email  bhaumik.dave@nuvo.ai  
 
Details of Contact Person
Scientific Query
 
Name  Ms Shikha Shah 
Designation  Assistant Manager 
Affiliation  Nuvo AI Pvt. Ltd 
Address  135/139 Bilakhia House Muktanand Marg Chala Vapi Pardi Valsad 396191 Gujarat

Valsad
GUJARAT
396191
India 
Phone  7666070543  
Fax    
Email  shikha.shah@nuvo.ai  
 
Details of Contact Person
Public Query
 
Name  Ms Shikha Shah 
Designation  Assistant Manager 
Affiliation  Nuvo AI Pvt. Ltd 
Address  135/139 Bilakhia House Muktanand Marg Chala Vapi Pardi Valsad 396191 Gujarat

Valsad
GUJARAT
396191
India 
Phone  7666070543  
Fax    
Email  shikha.shah@nuvo.ai  
 
Source of Monetary or Material Support  
Nuvo AI Pvt. Ltd 
 
Primary Sponsor  
Name  Nuvo AI Pvt. Ltd 
Address  135/139 Bilakhia House Muktanand Marg Chala Vapi Pardi Valsad 396191 Gujarat  
Type of Sponsor  Other [Artificial Intelligence company] 
 
Details of Secondary Sponsor  
Name  Address 
NIL  NIL 
 
Countries of Recruitment     India  
Sites of Study  
No of Sites = 1  
Name of Principal Investigator  Name of Site  Site Address  Phone/Fax/Email 
Dr Sanjeev Mahajan   Fortis Hospital   Chandigarh Road Mundian Kalan Ludhiana Punjab 141015
Ludhiana
PUNJAB 
98155 46360

sanjeev.mahajan@fortishealthcare.com 
 
Details of Ethics Committee
Modification(s)  
No of Ethics Committees= 5  
Name of Committee  Approval Status 
Institutional Ethics Committee  Approved 
Institutional Ethics Committee  Approved 
Institutional Ethics Committee  Approved 
Institutional Ethics Committee  Approved 
Institutional Ethics Committee  Approved 
 
Regulatory Clearance Status from DCGI  
Status 
Not Applicable 
 
Health Condition / Problems Studied  
Health Type  Condition 
Patients  (1) ICD-10 Condition: T798||Other early complications of trauma, (2) ICD-10 Condition: S920||Fracture of calcaneus, (3) ICD-10 Condition: S921||Fracture of talus, (4) ICD-10 Condition: S923||Fracture of metatarsal bone(s), (5) ICD-10 Condition: S924||Fracture of great toe, (6) ICD-10 Condition: S925||Fracture of lesser toe(s), (7) ICD-10 Condition: S928||Other fracture of foot, except ankle, (8) ICD-10 Condition: S820||Fracture of patella, (9) ICD-10 Condition: S821||Fracture of upper end of tibia, (10) ICD-10 Condition: S822||Fracture of shaft of tibia, (11) ICD-10 Condition: S823||Fracture of lower end of tibia, (12) ICD-10 Condition: S824||Fracture of shaft of fibula, (13) ICD-10 Condition: S825||Fracture of medial malleolus, (14) ICD-10 Condition: S826||Fracture of lateral malleolus, (15) ICD-10 Condition: S828||Other fractures of lower leg, (16) ICD-10 Condition: S720||Fracture of head and neck of femur, (17) ICD-10 Condition: S721||Pertrochanteric fracture, (18) ICD-10 Condition: S722||Subtrochanteric fracture of femur, (19) ICD-10 Condition: S723||Fracture of shaft of femur, (20) ICD-10 Condition: S724||Fracture of lower end of femur, (21) ICD-10 Condition: S728||Other fracture of femur, (22) ICD-10 Condition: S620||Fracture of navicular [scaphoid] bone of wrist, (23) ICD-10 Condition: S621||Fracture of other and unspecifiedcarpal bone(s), (24) ICD-10 Condition: S622||Fracture of first metacarpal bone, (25) ICD-10 Condition: S623||Fracture of other and unspecifiedmetacarpal bone, (26) ICD-10 Condition: S625||Fracture of thumb, (27) ICD-10 Condition: S626||Fracture of other and unspecifiedfinger(s), (28) ICD-10 Condition: S520||Fracture of upper end of ulna, (29) ICD-10 Condition: S521||Fracture of upper end of radius, (30) ICD-10 Condition: S522||Fracture of shaft of ulna, (31) ICD-10 Condition: S523||Fracture of shaft of radius, (32) ICD-10 Condition: S525||Fracture of lower end of radius, (33) ICD-10 Condition: S526||Fracture of lower end of ulna, (34) ICD-10 Condition: S420||Fracture of clavicle, (35) ICD-10 Condition: S421||Fracture of scapula, (36) ICD-10 Condition: S422||Fracture of upper end of humerus, (37) ICD-10 Condition: S422||Fracture of upper end of humerus, (38) ICD-10 Condition: S423||Fracture of shaft of humerus, (39) ICD-10 Condition: S424||Fracture of lower end of humerus, (40) ICD-10 Condition: S429||Fracture of shoulder girdle, partunspecified, (41) ICD-10 Condition: S490||Physeal fracture of upper end of humerus, (42) ICD-10 Condition: S491||Physeal fracture of lower end of humerus, (43) ICD-10 Condition: S498||Other specified injuries of shoulder and upper arm, (44) ICD-10 Condition: S590||Physeal fracture of lower end of ulna, (45) ICD-10 Condition: S591||Physeal fracture of upper end of radius, (46) ICD-10 Condition: S592||Physeal fracture of lower end of radius, (47) ICD-10 Condition: S598||Other specified injuries of elbowand forearm, (48) ICD-10 Condition: S698||Other specified injuries of wrist,hand and finger(s), (49) ICD-10 Condition: S790||Physeal fracture of upper end of femur, (50) ICD-10 Condition: S791||Physeal fracture of lower end of femur, (51) ICD-10 Condition: S798||Other specified injuries of hip and thigh, (52) ICD-10 Condition: S890||Physeal fracture of upper end of tibia, (53) ICD-10 Condition: S891||Physeal fracture of lower end of tibia, (54) ICD-10 Condition: S892||Physeal fracture of upper end of fibula, (55) ICD-10 Condition: S893||Physeal fracture of lower end of fibula, (56) ICD-10 Condition: S898||Other specified injuries of lowerleg, (57) ICD-10 Condition: S990||Physeal fracture of calcaneus, (58) ICD-10 Condition: S991||Physeal fracture of metatarsal, (59) ICD-10 Condition: S992||Physeal fracture of phalanx of toe, (60) ICD-10 Condition: S998||Other specified injuries of ankleand foot, (61) ICD-10 Condition: S390||Injury of muscle, fascia and tendon of abdomen, lower back and pelvis, (62) ICD-10 Condition: S320||Fracture of lumbar vertebra, (63) ICD-10 Condition: S321||Fracture of sacrum, (64) ICD-10 Condition: S322||Fracture of coccyx, (65) ICD-10 Condition: S323||Fracture of ilium, (66) ICD-10 Condition: S324||Fracture of acetabulum, (67) ICD-10 Condition: S325||Fracture of pubis, (68) ICD-10 Condition: S326||Fracture of ischium, (69) ICD-10 Condition: S328||Fracture of other parts of pelvis, (70) ICD-10 Condition: S220||Fracture of thoracic vertebra, (71) ICD-10 Condition: S222||Fracture of sternum, (72) ICD-10 Condition: S223||Fracture of one rib, (73) ICD-10 Condition: S224||Multiple fractures of ribs, (74) ICD-10 Condition: S298||Other specified injuries of thorax, (75) ICD-10 Condition: S120||Fracture of first cervical vertebra, (76) ICD-10 Condition: S121||Fracture of second cervical vertebra, (77) ICD-10 Condition: S122||Fracture of third cervical vertebra, (78) ICD-10 Condition: S123||Fracture of fourth cervical vertebra, (79) ICD-10 Condition: S124||Fracture of fifth cervical vertebra, (80) ICD-10 Condition: S125||Fracture of sixth cervical vertebra, (81) ICD-10 Condition: S126||Fracture of seventh cervical vertebra, (82) ICD-10 Condition: S128||Fracture of other parts of neck, (83) ICD-10 Condition: S198||Other specified injuries of neck, (84) ICD-10 Condition: S020||Fracture of vault of skull, (85) ICD-10 Condition: S021||Fracture of base of skull, (86) ICD-10 Condition: S022||Fracture of nasal bones, (87) ICD-10 Condition: S023||Fracture of orbital floor, (88) ICD-10 Condition: S024||Fracture of malar, maxillary and zygoma bones, (89) ICD-10 Condition: S026||Fracture of mandible, (90) ICD-10 Condition: S028||Fractures of other specified skulland facial bones, (91) ICD-10 Condition: S098||Other specified injuries of head,  
 
Intervention / Comparator Agent  
Type  Name  Details 
Intervention  NA  NA 
 
Inclusion Criteria  
Age From  18.00 Year(s)
Age To  99.00 Year(s)
Gender  Both 
Details  Retrospective arm:
1. Patients greater than equal to 18 years who underwent internal fixation of bone fractures in the past 2 years or more.
2. Availability of pre-operative, intra-operative and post-operative imaging (X-ray with/without CT scans) with acceptable quality for fracture classification and size estimation.
3. Complete surgical records detailing the type, size, and configuration of implants (Meril Healthcare Pvt. Ltd.) used.
4. Availability of post-operative and follow-up data including union status, complications, or revision surgery outcomes.

Prospective arm:
1. Patients greater than equal to 18 years presenting with acute fractures of bones requiring internal fixation with nails, screws, or plates.
2. Availability of digital imaging (X-ray ± CT) suitable for annotation and AI processing.
 
 
ExclusionCriteria 
Details  Retrospective arm:
1. Pathological fractures (e.g., metastatic, cystic, or osteoporotic collapse without trauma).
2. Polytrauma patients with incomplete imaging or missing clinical/surgical records.
3. Previous surgery on the same bone that alters normal anatomy or
complicates implant selection.
4. Inadequate imaging quality for AI analysis or missing calibration
for measurement.

Prospective arm:
1. Pathological fractures or periprosthetic fractures.
2. Pediatric patients (less than 18 years) due to differing implant selection
protocols.
3. Patients with incomplete imaging or poor-quality scans that do not
allow proper annotation.
4. Patients refusing consent for participation in the prospective arm.
 
 
Method of Generating Random Sequence   Not Applicable 
Method of Concealment   Not Applicable 
Blinding/Masking   Not Applicable 
Primary Outcome  
Outcome  TimePoints 
To develop and validate an AI-based decision support model that recommends the optimal type, size, and configuration of nails, screws, and implants for bone fracture fixation using structured imaging and clinical data.  15 months 
 
Secondary Outcome  
Outcome  TimePoints 
• To evaluate the accuracy and reliability of AI-generated implant recommendations compared to the treating surgeon’s decision.
• To assess clinical outcomes, including fracture union, implant related complications, and the need for revision surgeries, in cases where AI recommendations are applied.
• To measure the efficiency and utility of the AI tool in real-world orthopaedic workflows, including its impact on decision-making time.
• To establish a standardized, data-driven framework for implant selection that can reduce inter-surgeon variability and improve patient outcomes. 
15 months 
 
Target Sample Size   Total Sample Size="100000"
Sample Size from India="100000" 
Final Enrollment numbers achieved (Total)= "Applicable only for Completed/Terminated trials"
Final Enrollment numbers achieved (India)="Applicable only for Completed/Terminated trials" 
Phase of Trial   N/A 
Date of First Enrollment (India)   20/01/2026 
Date of Study Completion (India) Applicable only for Completed/Terminated trials 
Date of First Enrollment (Global)  Date Missing 
Date of Study Completion (Global) Applicable only for Completed/Terminated trials 
Estimated Duration of Trial   Years="1"
Months="3"
Days="0" 
Recruitment Status of Trial (Global)
Modification(s)  
Not Applicable 
Recruitment Status of Trial (India)  Open to Recruitment 
Publication Details   N/A 
Individual Participant Data (IPD) Sharing Statement

Will individual participant data (IPD) be shared publicly (including data dictionaries)?  

Response - NO
Brief Summary
Modification(s)  

Fracture management, particularly internal fixation using implants such as intramedullary nails, plates, and screws, is a critical aspect of orthopaedic surgery. Selecting the appropriate implant type, size, and configuration is often a complex and subjective process, influenced by fracture type, location, patient age, bone density, and fracture dimensions. Incorrect implant selection can lead to complications, including non-union, malunion, and implant failure. Therefore, this study aims to develop and validate an AI-based decision support system for recommending the most appropriate fixation devices and their sizes (nails, screws, and implants) for orthopedic fracture fixation. The system will utilize structured clinical and radiographic data, including fracture size, location, classification, and relevant patient parameters. The AI model will recommend optimal fixation strategies based on data sourced from patient populations, ensuring that it accounts for both clinical and imaging insights.

The study includes both retrospective and prospective arms for the research, and it involves patient data, including imaging and clinical data. In the retrospective arm, past patient cases are used to train and validate the AI model, while the prospective arm involves enrolling new fracture patients, collecting imaging and clinical data, and utilizing AI for implant recommendations.

Given that the study involves human data both retrospective (past cases) and prospective (new fracture patients), this trial will be conducted on human beings. This is based on the involvement of patient data, both historical (retrospective) and prospective (new patients), which includes human clinical and imaging data for the purposes of AI model training, validation, and outcome assessments.

 
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