TraumaCad Administrator's Guide 2.2 - Final.pdf - Voyant Health

TraumaCad 

Administrator's Guide 

Version 2.2 

An Orthocrat Ltd. Document 

Copyright 2009

ii 

Important Notice 

TraumaCad Administrator’s Guide 


Copyright and Trademark Notices 

All contents of this document are Copyright 2009 Orthocrat Ltd. 

All rights reserved. The trademarks, logos and service marks displayed on this document are 

the property of Orthocrat Ltd. or other third parties. Users are not permitted to use these 

trademarks, logos and service marks without the prior written consent of Orthocrat Ltd., or 

such third parties as may own them. 

Limited License 

Orthocrat Ltd. hereby gives license to review these documents solely for non-commercial 

use within your organization, provided that you do not modify the content of the documents 

and provided any copies made retain all copyright and other proprietary notices contained 

therein. The information provided in these documents is permitted solely to users to provide 

information in support of Orthocrat Ltd. products. No other use of the information provided 

hereunder is authorized. 

Nothing contained herein shall be construed as conferring by implication, estoppels or 

otherwise any license or right under any patent or trademark of Orthocrat Ltd. or any third 

party. Except as expressly provided above, nothing contained herein shall be construed as 

conferring any license or right under any Orthocrat Ltd. or third party copyright. 

Limitation of Liability 

Information provided on this document is provided "AS IS" and is provided without 

warranty of any kind, either expressed or implied, including, without limitation, warranties 

of merchantability, fitness for a particular purpose, and non-infringement. Orthocrat Ltd. 

uses reasonable efforts to include accurate and timely information on this website and 

periodically updates the information without notice. However, Orthocrat Ltd. makes no 

warranties or representations as to the accuracy or completeness of such information, and 

Orthocrat Ltd. assumes no liability or responsibility for errors or omissions in the content of 

this documents. Your use of these documents is AT YOUR OWN RISK. Under no 

circumstances and under no legal theory or provision shall Orthocrat Ltd. be liable to you or 

any other person for any direct, indirect, special, incidental, exemplary or consequential 

damages arising from your access to, or use of, these documents. 

Product information is subject to change without notice. Orthocrat retains the right to make 

improvements and/or changes in the products and/or the programs described in the 

publications and information provided on these documents at any time and without prior 

notice. Mention of non-Orthocrat Ltd. products or services is for information purposes only 

and constitutes neither an endorsement nor a recommendation of such products or services.



iii 

Third-Party Information 

These documents may contain information of parties other than Orthocrat Ltd. Such 

information is provided for your convenience and reference only. The said information is not 

under the control of Orthocrat Ltd., and Orthocrat Ltd. is not responsible for the contents of 

such information. The inclusion of this information does not imply any association with their 

operators or any endorsement of the said third parties by Orthocrat Ltd. 

Microsoft is a registered trademark of Microsoft Corporation, Agfa is a registered trademark 

of Agfa-Gevaert Group and Sectra is a registered trademark of Sectra Radisoft AB. 

Disclaimer 

This software is intended as a decision support system for persons who have received 

appropriate medical training, and should not be used as a sole basis for making clinical 

decisions pertaining to patient diagnosis, care, or management. All information derived from 

the software must be clinically reviewed regarding its plausibility before use in treating 

patients. Any deviation of the application of medical information from the program, other 

than the original design or intended use thereof, is not advised and is considered a misuse of 

the software product. For additional guidance, see published studies. 

0344 

This device complies with the Requirements of the 93/42/EEC Directive Concerning 

Medical Devices, as amended by Council Directive 2007/47/EC. 

Authorized representative address: 

Esdoornlaan 13 

3951 DB Maarn 

The Netherlands 

CEpartner4U B.V. 

Phone: +31.343.442.524 

Fax: +31.343.442.162 

Catalog Number: MK3U00177 rev A

iv 

Table of Contents 



About This Guide......................................................................................vi 

Contacting Us...........................................................................................vii 

Safety Symbols .........................................................................................vii 

Chapter 1: Introducing the TraumaCad Server .................................... 9 

What is the TraumaCad Server? .........................................................................................9 

Chapter 2: Getting Started with the TraumaCad Server.................... 11 

TraumaCad Server Setup Workflow.................................................................................11 

System Requirements..........................................................................................................13 

TraumaCad Server Requirements...................................................................................13 

TraumaCad Client Requirements ...................................................................................15 

Preparing for Installation ...................................................................................................16 

Installing the TraumaCad Server ......................................................................................17 

Verifying Proper Operation................................................................................................31 

Template Download .......................................................................................................31 

Preparing a TraumaCad Client .......................................................................................33 

Chapter 3: Configuring the TraumaCad Server.................................. 41 

Configuring the PACS Servers...........................................................................................42 

Configuring DICOM Properties ........................................................................................44 

Configuring Logging ...........................................................................................................49 

Reading Log Files ................................................................................................................51 

Creating a Logs Package.....................................................................................................53 

Download/Update Templates..............................................................................................54 

During the Downloading Process...................................................................................56



v 

Chapter 4: Configuring Security Settings .............................................57 

Turning Off Anonymous Access Authentication in IIS................................................... 58 

Adding the Network Service User ..................................................................................... 63 

Adding the Active Directory Group .................................................................................. 66 

Testing Security Settings .................................................................................................... 68 

Chapter 5: Scaling X-Rays ......................................................................69 

Calibration Spheres – Guidelines on Correct Placement ................................................ 69 

Introduction ................................................................................................................... 69 

Technique ...................................................................................................................... 70 

Chapter 6: Troubleshooting the TraumaCad Server...........................73 

DICOM Connectivity from/to TraumaCad Server.......................................................... 74 

TraumaCad Client Installation.......................................................................................... 75 

Disabling the Internet Explorer Popup Blocker............................................................. 75 

Defining the TraumaCad Server Home Page as a Trusted Site ..................................... 76 

TraumaCad Licensing with Proxy Server ........................................................................ 78 

Enabling TraumaCad Logging for Diagnostic Purposes................................................. 81 

Template Issues................................................................................................................... 82 

Viewing TraumaCad Server Logs ................................................................................. 82 

Requests for New Templates.............................................................................................. 83 

Using Medical Tools............................................................................................................ 83 

Re-signing TraumaCad Prerequisites............................................................................... 84 

Appendix A: Using SSL...........................................................................87 

Configuring SSL ................................................................................................................. 88 

Verifying that SSL is Working .......................................................................................... 96 

Index ..........................................................................................................99

vi 

About This Guide 


About This Guide 

TraumaCad is intended for surgeons who are performing preoperative 

evaluation and planning for orthopedic procedures. 

This guide is intended for TraumaCad system administrators. It describes 

the initial installation and setup stages of the TraumaCad server and how to 

perform ongoing configuration modifications when required. 

This guide contains the following chapters: 

• Chapter 1, Introducing the TraumaCad Server, page 9, describes 

the purpose of the TraumaCad server and the TraumaCad DICOM 

workflow. 

• Chapter 2, Getting Started with the TraumaCad Server, page 11, 

describes the process of getting the TraumaCad server up and running. 

• Chapter 3, Configuring the TraumaCad Server, page 41, describes 

how to configure the TraumaCad server using the control panel. 

• Chapter 4, Configuring Security Settings, page 57, describes how to 

configure TraumaCad security settings so that each time a TraumaCad 

client is launched it requests an authorized user name and password. 

• Chapter 5, Scaling X-Rays, page 69, describes how to use the scaling 

sphere for X-ray calibration. 

• Chapter 6, Troubleshooting the TraumaCad Server, page 73, 

describes how to troubleshoot problems that may arise. 

• Appendix A, Using SSL, page 87, describes how to configure the 

usage of SSL with TraumaCad and how to verify that it is operating 

properly.

Contacting Us 


vii 

Contacting Us 

Headquarters 

35 Efal St, 12th floor 

Petah-Tikva, 49511, Israel 

Telephone +972-3-9290929 

Fax +972-3-9236413 

US Office 

Toll Free (866) 717 0272 

Fax (801) 881-5239 

UK Office 

Toll Free 00-800-9290-9290 

Fax +44 207 692 7865 

info@traumacad.com 

support@traumacad.com 

Safety Symbols 

The following symbols are used throughout the documentation. Please pay 

particular attention at specific points in a procedure when one of the 

following messages appears. 

WARNING! 

A WARNING! denotes a hazard. It calls attention to a procedure that, if not 

correctly performed or adhered to, could result in injury or loss of life. Do not 

proceed beyond a warning note until the indicated conditions are fully understood 

and met. 

NOTE: 

Notes provide pertinent information to help obtain optimum performance from the 

program. 

! IMPORTANT: 

Denotes important information to which you should adhere.

viii 

Safety Symbols 


This page was intentionally left blank.

Introducing the TraumaCad Server 


9 

3Chapter 1 

Introducing the 

TraumaCad Server 

What is the TraumaCad Server? 

The following describes the purpose of the TraumaCad server and the 

TraumaCad DICOM workflow. 

The TraumaCad server centralizes access to the archived PACS DICOM 

images in order to enable the orthopedic surgeon to seamlessly perform 

preoperative planning. The TraumaCad server enables them to find 

(C-FIND), retrieve (C-MOVE) and commit (C-STORE) DICOM images 

from and to a PACS server, as follows: 

2 

Image Queries (C-Find) 

3 

1 4 

HTTP / HTTPS 

Image Retrievals (C-Move) 

5 

Send Images (C-SEND / C-Store) 

TraumaCad TM Clients 

Optional Firewall 

TraumaCad TM Sever 

PACS Server

10 

Introducing the TraumaCad Server 


► The following describes the TraumaCad DICOM workflow: 

1 A user of the TraumaCad client application requests to query or retrieve 

a DICOM image. 

2 This request is made through the TraumaCad server which performs the 

query (C-FIND) or retrieval (C-MOVE) on behalf of the TraumaCad 

client. The session number is retained in the server’s session table. 

3 The TraumaCad server receives the image information or the images 

from the PACS server and forwards them to the TraumaCad client for 

templating though the HTTP port (port 80) or HTTPS (port 443). 

4 When the user requests to do so, the TraumaCad client requests the 

TraumaCad server to commit (C-STORE) the templated image to the 

PACS. 

5 The TraumaCad server forwards this request to the PACS and delivers 

the files to it. 

NOTE: 

No medical data is stored on the TraumaCad server. The TraumaCad server 

disconnects from the client after 30 seconds of inactivity on the client 

application. The images are deleted from the server’s memory cache and the 

session table holding the session number is cleared.

Getting Started with the TraumaCad Server 


11 

4Chapter 2 

Getting Started with 

the TraumaCad Server 

TraumaCad Server Setup Workflow 

The process of getting the TraumaCad server up and running is as follows: 

Step 1 

Verifying System 

Requirements 

Step 2 

Preparing for Installation 

Step 3 

Installing the 


Step 4 

Configuring the 


Step 5 

Verifying Proper TraumaCad 

Server Operation 

Step 6 

Configuring Security Settings 

[Optional] 

Step 7 

Installing TraumaCad Clients

12 



Step 1: Verifying System Requirements: Verify that the machine on 

which the TraumaCad server is installed and the machines on which the 

TraumaCad clients are installed meet the requirements listed in the System 

Requirements section on page 13. 

Step 2: Preparing for Installation: Before installing the TraumaCad 

server, follow the instructions in the Preparing for Installation section on 

page 16. 

Step 3: Installing the TraumaCad Server: Install the TraumaCad server 

software, as described in the Installing the TraumaCad Server section on 

page 17. 

Step 4: Configuring the TraumaCad Server: Configure the TraumaCad 

server, as described in Chapter 3, Configuring the TraumaCad Server on 

page 41. 

The first two sections of this chapter (Configuring the PACS Servers and 

Configuring DICOM Properties) must be configured before the server can 

operate. 

All other settings are installed with defaults that enable you to work 

comfortably. 

Step 5: Verifying Proper TraumaCad Server Operation: Check that at 

least one TraumaCad client can connect to the TraumaCad server and that it 

can query, retrieve and commit images from and to the PACS, as described 

in the Verifying Proper Operation section on page 31. 

Step 6: Configuring Security Settings: [Optional] Configure TraumaCad 

security settings so that each time a TraumaCad client is launched it 

requests an authorized user name and password, as described in the 

Chapter 4, Configuring Security Settings section on page 57. 

Step 7: Installing TraumaCad Clients: TraumaCad Clients can now be 

installed.



13 

System Requirements 

! 

IMPORTANT: 

The following describes the requirements for the TraumaCad server, below, 

and the TraumaCad client, as described on page 15. 

TraumaCad Server Requirements 

Before you begin installation, please verify that all prerequisite software 

components are installed and that the minimum hardware requirements are met, as 

described below. 

This section assumes that the reader is familiar with basic Windows 2003 

server administration. 

To install the TraumaCad Server, you must be logged-on as a user with 

administrative privileges. 

Before installing TraumaCad server, please define TraumaCad as a DICOM 

node in your PACS system and supply the details (as configured) to 

TraumaCad support and the implementation engineer. 

The following details must be configured: 

• IP address (of TraumaCad server) 

• AE title of TraumaCad Server 

• Port to be used for DICOM traffic (C-FIND, C-MOVE, C-STORE) 

If IIS requires an SSL certificate, then this certificate must be installed on 

the TraumaCad server prior to its installation. Ensure that the certificate has 

the correct server Fully Qualified Domain Name (FQDN).

14 



Software Server Requirements 

• Windows 2003 Server Standard / Enterprise Edition (English only) 

• Windows 2003 Server SP2 

• MS Internet Information Services (IIS) 6 

• MS Windows update (including all patches and hot fixes available at 

Microsoft Windows update) 

• Microsoft ASP.NET 

• Microsoft .NET Framework V2.0 

• Operating system installation CD files (to be copied to the server’s 

local hard drive; the I386 directory is mandatory) 

• Acrobat Reader 

• RDP / VNC (recommended for installation and ongoing support) 

Minimum Server Requirements 

• Dual-core Intel ® Xeon ® ; 4MB cache; 1.6 GHz 

• 1 GB RAM or more 

• Hard Drive: 

• Up to 1 GB for the Software 

• Up to 2 GB for Digital Templates 

• Permanent Internet Connection 

• 1024x768 Screen Resolution 

• Open Internet access to https://templates.traumacad.com (for automatic 

template library updates) and http:// license.traumacad.com (for license 

renewals) 

Recommended Server Requirements 

• 2 x Dual-core Intel Xeon E5205 / Quad-core E7310 Xeon 

• 2-4 GB RAM 

TraumaCad Server installation is supported on VMware as long as the 

Virtual machine meets the above requirements.



15 

TraumaCad Client Requirements 

! IMPORTANT: 

Before you begin installation, please verify that all prerequisite software components 

are installed and that the minimum hardware requirements are met as described below. 

This section assumes that the reader is familiar with basic Windows XP 

administration. 

To install TraumaCad client, you must be logged-on as a user with 

administrative privileges. 

Software Client Requirements 

• Windows XP Professional 32-bit or Windows VISTA Business 

32-bit/64-bit (English should be the default operating system language. 

Other languages can coexist.) 

• Windows XP SP2/SP3 / Windows VISTA SP1 

• MS Windows update (all patches and hot fixes available at Microsoft 

Windows update) 

• Microsoft .NET Framework V3.5 

• DirectX 9.0 or above 

• IE version 6 SP 1 (or above) 

• I386 directory from the installation CD 

• Acrobat Reader 

• VNC, pcAnywhere or MS Terminal [Remote Desktop connection] 

(recommended for installation and ongoing support) 

Client and Network Requirements 

Minimum Client Requirements 

• Pentium 4 (2.4 GHz or faster) 

• 512 MB RAM or more 

• Hard Drive: Up to 75 MB for the software 

• 1024x768 Screen Resolution 

Recommended Client Requirements 

• Intel Dual-core or Xeon (3 GHz or faster) 

• 2 GB RAM

16 



Preparing for Installation 

Before installing the TraumaCad server, perform the following: 

• Verify that the system on which the TraumaCad server is to be installed 

complies with all system requirements as specified in the System 

Requirements section on page 13. 

• If you want the TraumaCad server application to run using SSL, then 

you must install an SSL certificate on the machine before installing the 

TraumaCad server application. 

If you decide that you want the TraumaCad server application to run 

using SSL after the TraumaCad server application has already been 

installed, please install the SSL certificate according to Appendix A, 

Using SSL, on page 87. Reboot the server and enable SSL using the 

Start menu Orthocrat menu item. 

• Before installing TraumaCad server, define TraumaCad as a DICOM 

node in your PACS server and supply the configuration details to the 

TraumaCad support representative and/or the implementation engineer 

as follows: 

• IP address of TraumaCad server 

• Application Entity (AE) Title of TraumaCad Server 

• Port to be used for DICOM traffic (C-FIND, C-MOVE, C-STORE) 

Please visit the following URL in order to check the connectivity of the 

TraumaCad server box to our online licensing server: 

http://license.traumacad.com/LicenseIssueWs/IssueService.asmx 

If a list of services is displayed, it means that the TraumaCad server can 

connect to our server. 

If this list is not displayed, it means that the TraumaCad server 

computer is not connected to the Internet, or that the firewall/proxy in 

your organization is blocking this connection. In this case, contact your 

system administrator to enable this connection.



17 

Installing the TraumaCad Server 

NOTE: 

Installation and configuration of the TraumaCad server must be performed before 

installing TraumaCad clients. 

Before installing the TraumaCad server, make sure that you have followed 

the instructions provided in the System Requirements section on page 13 

and the Preparing for Installation section on page 16. 

► To install TraumaCad: 

1 Make sure that you have the latest TraumaCad server installation program 

provided by the TraumaCad support team. This can be downloaded from 

the web through a link provided by the TraumaCad support team or from a 

CD supplied in the TraumaCad installation package. 

2 Launch the TraumaCad installation program. The following window 

appears after a few moments:

18 



3 Click Next and then accept the terms of the license agreement in the 

window that follows. 

4 Click Next to display the following window: 

5 [Optional] Select a location on the server in which to install the web 

application files and the template files. 

NOTE: 

Traumcad 2.2 supports saving the template files in a NAS (Network Area 

Storage) or a SAN (Storage Area Network) storage device. 

Click the Change... button to select a destination folder other than the 

default location as shown in the window.



19 


7 Specify the Site Name or Hospital Name on which the server is 

installed, in accordance with the purchase order supplied to the 

Orthocrat sales representative. This name is important for template 

updates and support renewal. It is not case sensitive. 

8 The TraumaCad 2.2 client supports working with multiple servers and 

different versions. In order to distinguish between the servers with which 

the client works, you should place the applicable display name next to the 

TraumaCad start menu icon on the client side in the following window. By 

default, the system uses the Site Name provided in Step 7 above.

20 




The following configuration settings can be selected in this window, 

Website, Proxy Settings and SSL Certificate. According to the 

selection made by checking the relevant checkbox, various options will 

be displayed automatically after you click the Next button in each 

window. 

These configuration settings are described in the subsequent sections: 

• Website, on page 21 

• SSL Certificate, on page 22 

• Proxy Settings, on page 23



21 

Website 

You can specify that the TraumaCad server will be installed as the 

default website on the IIS server or that it is installed on an existing 

web server not using the default website 

• To install the TraumaCad server under the default website, check the 

Default Website checkbox. 

• To install the TraumaCad server on an existing web server under a 

NEW website, uncheck the checkbox. 

If you unchecked the Default Website checkbox, then the following 

window is displayed: 

Specify the following in this window: 

• In the Description field, specify the description of the new 

TraumaCad website to open. The default name is 

TraumaCadServer. 

NOTE: 

We recommend leaving the default name as-is. 

• In the TCP Port field, specify a new IIS port for HTTP 

communication between the TraumaCad server and its clients (the 

default port is 8080).

22 



SSL Certificate 

To specify that the TraumaCad server application will run using SSL, 

check the Use SSL checkbox, as shown below: 

NOTE: 

If you want the TraumaCad server application to run using SSL, then you must 

install an SSL certificate on the machine before installing the TraumaCad 

server application. 

If you decide that you want the TraumaCad server application to run using 

SSL after the TraumaCad server application has already been installed, 

Please install the SSL certificate according to Appendix A, Using SSL on page 

87. Reboot the server and enable SSL using the Start menu Orthocrat 

menu item.



23 

Proxy Settings 

If your organization uses a proxy server that caches Internet pages and 

you would like TraumaCad to automatically update templates on a 

weekly basis, then select the Use Proxy Server checkbox. 

NOTE: 

One of the nice features of Version 2.0 is that it enables the templates update 

process to run through the organization’s proxy server.

24 



• Click Next and configure the details in the following window: 

This Proxy Settings window is comprised of two segments: 

• Proxy Server Settings: The Address and Port fields are 

mandatory. 

• Proxy Server User: These fields are not mandatory and they should 

be filled in according to the proxy server configuration, since you 

can configure the proxy server to use credentials or not 

(anonymously).



25 

10 After you fill out and click Next in the windows that appear in the 

previous step, the Install window appears, as shown below: 

Click Install and wait up to several minutes while the following 

window is displayed:

26 



During installation, several flashing command line windows appear, as 

shown below: 

Wait for the installation process to complete. Do not take any action. 

If during the installation the following window is displayed, then the 

installer was not able to perform NSLOOKUP. In this case, enter your 

server’s FQDN or IP address in the text box and click OK. This 

information is saved in the client MSI file. 

Upon completion of installation, the following icon appears on your 

desktop:



27 

The TraumaCad Server Control Panel provides the web pages 

through which you can configure the TraumaCad server, as described 

in Chapter 3, Configuring the TraumaCad Server on page 41. 

11 Click Finish. 

In some cases (depending on the IIS configuration of your web server), 

you are prompted to restart the TraumaCad server before you can enter 

the license for the system, as shown below: 

12 If this prompt is displayed, click Yes to restart.

28 



13 After the server reboots, open the TraumaCad Server Control Panel 

icon from the desktop. The Online Activation window is 

displayed, as shown below: 

14 Paste or type the activation key that was received from the TraumaCad 

support team by email or that is printed on the TraumaCad server 

installation box, into the Activation Key field and click the Activate 

Online button. 

Its format is similar to x-xxxx-xxxx-xxxx-xxxx. 

! IMPORTANT: 

During this stage, the TraumaCad server must be connected to the Internet to 

enable online license activation.



29 

The Web Page Dialog window is then displayed in which you must 

register the product. 

15 Click OK and the following message appears:

30 



16 Click OK and you are redirected to the TraumaCad Server Control 

Panel, as shown below: 

! 

IMPORTANT: 

Make sure to perform the following two procedures before trying to use 

TraumaCad. 

• Configuring the PACS Servers, as described in the Configuring the 

PACS Servers section on page 42. 

• Configuring DICOM Properties, as described in the Configuring 

DICOM Properties section on page 44.



31 

Verifying Proper Operation 

Template Download 

► To download a template: 

Enter the TraumaCad Server Control Panel and click the Templates 

Updating Service box on the bottom left of the window. You are then 

redirected to the Templates Service Status page and the templates update is 

shown to be in progress. 

! 

IMPORTANT: 

If the Templates Updating Service does not start, you should check that the 

server has open Internet access to HTTPS://templates.Traumacad.com with the 

ability to download the following file extensions: *.oc2, *.oti, *.txt.

32 



If the Templates Updating Service still does not start: 

• Configure your proxy server settings inside the TraumaCad Server 

Control Panel by clicking the Status button on the top left of the 

window. 

• Then, in the Main Control Panel window, click Configure Proxy 

Settings to display the following window: 

These fields should have been set up during the normal installation process. 

If these fields have not been filled in, complete them as required or verify 

that the existing settings are correct. Click the Back to status page prompt 

to return to the Templates Service Status page. This downloading process 

may take up to an hour depending on the speed of your Internet connection. 

NOTE: 

While the download process is in progress, the user can continue working on the 

system.



33 

Preparing a TraumaCad Client 

After you have installed and configured the TraumaCad server, you should 

check that at least one TraumaCad client can connect to the TraumaCad 

server and that it can query, retrieve and commit from and to the PACS. An 

example procedure for doing this is provided below. 

NOTE: 

You should also verify that each workstation on which a TraumaCad client is 

installed meets the requirements listed in the TraumaCad Client Requirements 

section on page 15. 

► To prepare a TraumaCad client: 

1 Use Internet Explorer to access the TraumaCad server home page 

located at: 

http: //< TraumaCad server IP address>/TraumaCadserver/ 

This address should correspond to any modifications that you made in 

the installer. This means that if you installed the server on a website 

other than the default website or if you chose to use SSL, this 

information should be reflected in the URL (server name and/or port 

number). 

When the page opens, wait for 10 seconds or click the link shown 

below:

34 



These actions open a window such as the one shown below for 

installing the TraumaCad Prerequisites MSI: 

The MSI installs the TraumaCad client, as described in the following 

steps. 

2 Click the Run button to install the TraumaCad Prerequisites MSI. 

After the prerequisites file is installed, the TraumaCad client 

installation starts automatically. A window similar to the one below is 

displayed:



35 

After installation, the TraumaCad window opens, as shown below: 

3 Select a procedure and verify that the address of the TraumaCad server 

appears in the title bar of the window. 

The TraumaCad client opens according to the client configuration 

defined for the TraumaCad server, as set by your system 

administrator (certain features can be enabled or disabled by the 

administrator).

36 



4 Verify that the PACS server that you defined, as described in the 

Configuring the PACS Servers section on page 42, appears as a radio 

button at the top middle of the window. 

5 Query the PACS for patient information by clicking the Query button.



37 

6 Retrieve an image from the PACS by double-clicking a patient name in 

the list. One or more images should appear as thumbnails on the left, as 

shown below:

38 



7 Commit an image to the PACS by: 

• Selecting an orientation (AP or Lat, Left or Right) and clicking the 

button. The image then opens in the main view and the 

TraumaCad Image Calibration window appears on the left, as 

shown below: 

• Click the Accept button in the TraumaCad Image Calibration 

window. 

• Click an area in the main image view, and then click the Text 

Annotation 

annotation. 

tool in the menu bar and type in a textual 

• Click OK and the annotation appears on the image.



39 

• Click the Report tab on the left top and then click the Save Case button. 

• Check the PACS checkbox and click OK. A green checkmark 

indicates that the image was successfully committed to the PACS. 

• Click the Close button to close this window. 

• Open the File menu and select Exit to close the application.

40 



If any of these processes do not work, then: 

• Check the PACS configuration on the TraumaCad server by verifying 

the correctness of the PACS IP address, AE titles and ports. 

• Check the TraumaCad server configuration on the PACS by verifying 

the correctness of the TraumaCad server IP address, AE titles and ports. 

• Restart the IIS on the TraumaCad server, restart the TraumaCad client 

and test the workstation again.

Configuring the TraumaCad Server 


41 

5Chapter 3 

Configuring the 


About This Chapter 

This chapter contains the following sections: 

• Configuring the PACS Servers, page 42 

• Configuring DICOM Properties, page 44 

• Configuring Logging, page 49 

• Reading Log Files, page 51 

• Creating a Log Package, page 53 

• Download/Update Templates, page 54

42 



Configuring the PACS Servers 

This step describes how to configure the TraumaCad server to connect to 

the PACS servers in order to access DICOM images. 

► To configure the connection to the PACS servers: 

1 Click the PACS Servers button to display the following 

window: 

2 Click the Add Server button to display a table, as shown below:



43 

3 Define a PACS server to which the TraumaCad server can connect by 

filling in the following fields. Double-click a field to edit it. 

Each row represents a single PACS. You can define more than one 

PACS by filling in one per row, as follows: 

• Server Name: PACS server name. 

• Application Entity Title: PACS AE title. 

• PACS Query System Port: This is the port used to query and 

retrieve images from the PACS (C-FIND and C-MOVE). 

• Server IP Address: The IP address of the PACS server. 

• DICOM Send Port: This is the port used for committing images to 

the PACS (C-STORE). 

• Send By Default: If you have more then one DICOM archive and 

you would like to have each templated image on each of the 

archives, click this box for each PACS to which to commit the 

image. 

4 Click Save Settings after you enter each row.

44 



Configuring DICOM Properties 

This step describes how to configure the TraumaCad server as a DICOM node 

and additional configuration steps for the TraumaCad workstations and PACS 

systems that the TraumaCad server will work with (as described below). 

► To configure DICOM properties: 

Local DICOM Properties 

1 Click the DICOM Properties/Default Servers button to 

display the following window:



45 

2 Fill out the Local DICOM Properties, as follows: 

• DICOM Server Port: This is the port number to be used to query 

(C-FIND), retrieve (C-MOVE) and commit (C-STORE) from/to the 

PACS from TraumaCad. 

• Local Application Entity: TraumaCad Application Entity in the PACS. 

Default Server Settings 

3 Fill out the Default Server Settings. 

• Default Compression Quality: The use of compression enables an 

end-user to display an image faster, but may compromise the quality 

of the image. There are three default compression options: None, 

Lossy and Lossless as shown below: 

• Default Compression Ratio: Compression can be performed at a 

specific ratio. Smaller ratios result in smaller and lower quality 

images and higher ratios result in only a slight reduction in image 

size and higher quality images. For example, a ratio of 100% reduces 

file size slightly and results in a good quality image. 

If you only defined one PACS server in the Configuring the PACS 

Servers section, as described on page 42, then this PACS server 

automatically appears in the Default Server Settings area in the 

Default QR Server and the Default Send Server fields. In this case, 

skip to Step 5. 

If you defined more than one PACS server in the Configuring the 

PACS Servers section, as described on page 42, then you can specify 

which PACS server is used for each type of operation: 

• In the Default QR Server dropdown field, select the PACS server to 

be used by default for querying and retrieving (C-FIND and 

C-MOVE) to/from the PACS. 

• In the Default Send Server dropdown field, select the PACS server 

to be used by default for sending (C-STORE) to the PACS.

46 



TraumaCad Workstation Properties 

If you have configured only one PACS server, you must select the Default 

PACS radio button, which indicates that the system uses the server 

specified in the Default QR Server and the Default Send Server fields. 

In the example below, the configuration on the left shows the definition of a 

single PACS server (C-FIND, C-MOVE and C-STORE are located on the 

same PACS server with the same Application Entity (AE) title.) The 

configuration on the right shows the definition of different PACS servers 

(C-FIND, C-MOVE and C-STORE are located on different PACS servers 

or use different AE titles). 

4 Fill out the TraumaCad Workstation Properties, as follows: 

• Allow Import of Dicom files on the workstations: Check this 

option to specify that the Import Image button is available on the 

TraumaCad workstations. The button, shown below, is located on 

the TraumaCad client. It enables the users to import either DICOM 

images or images from another source, such as: a CD, digital camera 

and so on.



47 

• Allow Report of multiple studies: Check this option to allow users 

to template on several images from several studies for the same 

patient and store them together on the PACS. This configuration is 

designed for specific PACS systems on which each studyUID or 

Accession # contains only one image. In some cases, users may need 

to template on AP and LAT images from different studies. 

• Enable queries on the workstations: Check this option to specify 

that the Query button is available on the TraumaCad workstations. 

This button enables the users to find patients according to criteria 

that they specify, such as: Last / First Name, Patient ID, Study Date 

and so on. The images are retrieved from the PACS server according 

to the configuration on both sides. You must configure both the 

TraumaCad Default Server Settings and the PACS system). 

• Committing images to: Please refer to Step 3 in the Configuring 

the PACS Servers section, as described on page 42, for a description 

of this field. 

• Commit as modality: Specify the modality type of the system. If 

this field is left blank, then the original modality type of the image is 

retained. An example of the usage of this field is when a hospital 

would like to indicate that preoperative planning information was 

added as an additional series. In this case, you might enter 

Orthopedic Templating (OT) in this field. 

• Skip auto-calibration feature: Check this option to specify that the 

automatic calibration feature that is used in TraumaCad workstations 

is disabled. 

• Metal Ball Diameter: Enter the diameter of the calibration metal 

ball (if applicable). The default is 1" inch (25.4mm). 

• Default commit resolution: This option enables the system 

administrator to decide whether the images that have been 

manipulated in the TraumaCad client are committed (C-STORE) to 

the PACS using the original image resolution (according to the 

DICOM header in the image) or according to the screen resolution in 

which the TraumaCad client is displayed.

48 



NOTE: 

This is a cross organizational configuration, meaning that all the 

workstations are configured the same way without the ability to change the 

default settings from the client side. Any selection made here affect all the 

workstations and causes them to operate according to these settings. 

• Client inactivity timeout: If TraumaCad client is open, but is not 

currently being worked on (is dormant), a timeout occurs after the 

designated period of time specified in this field and the software 

closes down. It is important to note that all work performed on 

the client up to the time of the timeout is lost without the ability 

to restore it. This is a security feature. 

• Fuji Integration Version [Optional]: This only applies if you are 

working with a Fuji Synapse PACS system. (If you are using a 

different PACS system, then leave the default value at version 3.2). 

Due to various changes made in the Fuji integration services, you 

must specify your Fuji Synapse version. Only version 3.1 and 3.2 are 

supported. (The minor version, which is the third set of digits in a 

version number, is not relevant.) 

• Regex [Optional]: This option is specific to non-English, 

Fuji-integrated systems. Consult the Orthocrat Global Support 

Center before applying this setting if your server works with a 

non-English, Fuji system. 

5 Click Save Settings to save all these settings to the TraumaCad server 

and a confirmation window is displayed. 

If you have not been able to query/retrieve or commit back to the PACS 

system and you have checked that the configuration on both sides is 

correct, then please click the Restart Dicom Proxy button. This will restart 

TraumaCad Server’s DICOM component.



49 

Configuring Logging 

This step describes how to configure the TraumaCad server logging 

options. 

► To configure the TraumaCad server logging options: 

1 Click the Configure Logging button to display the 

following window: 

2 In the Log files folder field, specify the directory in which to store the 

logs. The logs (by default) are located in: 

C:\Program Files\Orthocrat\TraumaCadServer\Logs 

3 Check one or more relevant options in the TraumaCad logging filter 

area in order to specify the depth and type of information that is logged 

by the TraumaCad server, as follows. 

• Debug: For internal use by TraumaCad support representatives. 

• Warning: Logs system warnings. This is the default. 

• Action: Provides an audit trail of each action performed by the 

users on the TraumaCad clients. 

The default option is Warning. We recommend that you leave these 

settings as they are.

50 



! IMPORTANT: 

If you detect a problem in the system, we recommend that you check all the 

logging options described above and then repeat the action that caused the 

problem. Afterwards, use the Read Log Files button located in the 

TraumaCad Server Control Panel to access the Create Package button to 

create a package of the relevant log files and send this package by email to 

support@traumacad.com. Make sure to specify your site name in the subject 

of the email. You may refer to the Creating a Logs Package section on 

page 53 . 

4 In the DicomProxy logging filter area select one of the following 

options in order to specify the level of details stored in the DICOM 

logs. 

The DICOM Object Logs field is designed for DICOM actions 

between the TraumaCad server and the PACS system, in order to 

identify any inconsistencies during the communication between the 

systems. The options are as follows: 

• Errors and main events only (Smallest): We recommend leaving 

this option checked at all times. 

• Most Data (Medium): Use this option for DICOM troubleshooting 

purposes. 

• A full byte level log (Full log): Use this option for extensive 

logging and ONLY after consulting with TraumaCad support. 

The DICOM logs are located in: 

C:\Program Files\Orthocrat\TraumaCadServer\Logs\DicomObjects 

! IMPORTANT: 

If either of the two last options are selected, the resulting log files are very 

large in size (a minimum of 50 MB up to 50 GBs). 

5 Click Save Settings to save all these settings to the TraumaCad server.



51 

Reading Log Files 

This section describes how to view the log files, which can be used for 

troubleshooting purposes. 

► To view log files: 

Click the Read Log Files button 

to the following: 

to display a window similar 

Each row in the window represents a separate log file. A log file is started 

each new day and each time the TraumaCad server is restarted. 

NOTE: 

Typically, the TraumaCad server should be restarted at least once a month. 

The display of the logs shows the following columns: 

• Log File Name: The name of the log file. The name of each log file is 

in the noted format according to the day on which it was recorded. 

• Last Activity At: The date and time of the last activity logged in this 

file. 

• Created Date: The date and time of the first activity logged in this file.

52 



• View: Provides a link (called Display) that you can click to view the 

log entries in this log file. The following types of logs are recorded by 

the TraumaCad server: 

• Main TraceYYYY-MM-DD HH-MM-SS.log: Shows the actions 

of the main web service of the TraumaCad server. Usually, this log 

contains actions, error messages and warnings. 

• Control_Panel_TraceYYYY-MM-DD HH-MM-SS.log: Monitors 

all the changes that have been made in the system control panel and 

contains the licensing validation. 

• License_TraceYYYY-MM-DD HH-MM-SS.log: Contains license 

activate details. 

• Templates Update Service_Trace.YYYY-MM-DD HH-MM- 

SS.log: Specifies the automatic templates download service actions 

performed. 

• DicomProxy Trace.YYYY-MM-DD HH-MM-SS.log: Contains 

information about the TraumaCad server DICOM component. 

• Audit.log: Displays all the query, retrieve and commit-related 

actions that have been taken in the TraumaCad client. 

• D.O.Netxxxxxxxx.xxxxxx.xxxxx.x.log (DICOM Object Logs): 

Contains details about the DICOM actions that occurred in the 

system. 

NOTE: 

Some logs appear again with the suffix Errors in their name. This means 

that this log contains errors that are related to this specific component of the 

system. 

• Download: Click to download the log file to your computer in order to 

provide it to TraumaCad support if needed.



53 

Creating a Logs Package 

The system creates a logs package that contains all the relevant logs to 

enable TraumaCad support engineers to troubleshoot any DICOM-related 

issue in the system. 

► To create a package: 

Click the Create a package button 

. The server creates 

a ZIP package that includes your TraumaCad server license number and a 

date and time as displayed below: 

In the event of troubleshooting, send this log file via email to 

support@traumacad.com with a description of the problem (including 

screenshots if possible). Attach the package and specify the site name and 

your TraumaCad license number in the subject of the email (they can be 

found on the Status page).

54 



Download/Update Templates 

This section describes the processing of downloading and updating the 

latest templates to the TraumaCad server. This process is activated in order 

to download and update the latest templates from the Orthocrat online 

database to your local TraumaCad server’s templates library, so that they 

can be served to the TraumaCad workstations.



55 

It is activated in the following cases: 

• Automatically after installation, this process may take up to an hour 

depending on your Internet bandwidth. 

• TraumaCad templates database timetable. Each TraumaCad server 

receives its own timeslot during which it automatically updates its 

templates. This process it totally automatic and the schedule cannot be 

changed by you. In order to request a different update slot, please 

contact TraumaCad support at support@traumacad.com and specify 

your site name in the subject of the email and your timeslot request 

(TraumaCad support team will try to accept your request according to 

the available time slots in the system). 

• Manually on an as-needed basis. This option is typically used when 

the TraumaCad server is not continuously connected to the Internet. To 

use this option, connect to the Internet, download and then disconnect 

using the Update Templates Now button. 

In the Service control area, you can stop or start this service. Stopping the 

service while it is running may take a few minutes. Once you stop the 

service, it remains stopped until the TraumaCad Templates Update Service 

is restarted by pressing the Start Service button or by restarting the 

TraumaCad server.

56 



During the Downloading Process 

This process is activated automatically after installation and may take up to 

an hour. During this time do not restart IIS or reboot the server. 

While the TraumaCad server is downloading, the following message is 

displayed: 

During the template update process, after connecting to the TraumaCad 

templates database, the index file is downloaded and then compared to the 

local index file. TraumaCad server then starts to download new and 

updated templates.



57 

6Chapter 4 

Configuring Security 

Settings 

This step is optional. You can use it to configure TraumaCad security 

settings so that each time a TraumaCad client application is launched, it 

requests an authorized user name and password, as shown below:

58 



Turning Off Anonymous Access 

Authentication in IIS 

Turn off anonymous access authentication in IIS for the TCWAuth.asmx 

file under Security, as follows:



59 

► To turn off anonymous access authentication in IIS: 

1 Open the IIS Manager. 

2 Right-click TCWAuth.asmx and select Properties from the menu. 

The TCWAuth.asmx Properties window is displayed. 

3 In the File Security tab, click the Edit button. The Authentication 

Methods window is displayed. 

• Uncheck the Enable anonymous access checkbox. 

• Verify that the .NET Passport authentication checkbox is 

unchecked. 

• Click OK to exit this window and then OK again in the 

TCWAuth.asmx window.

60 



4 Open the Security folder under IIS (C:\Program 

Files\Orthocrat\TraumaCadServer\Web\Security) and set the security 

options for the TCWAuth.asmx file, as follows: 

5 Right-click TCWAuth.asmx at 

C:\Program Files\Orthocrat\TraumaCadServer\Web\Security and 

select Properties from the menu. The TCWAuth.asmx Properties 

window is displayed.



61 

6 In the Security tab, click the Advanced button. The Advanced Security 

Settings for TCWAuth.asmx window is displayed: 

7 Uncheck the Allow inheritable permissions… checkbox. The 

following window is then displayed:

62 



8 Click the Copy button and then OK. The TCWAuth.asmx Properties 

window is then displayed showing the same users group (without 

inheritable permissions), as shown below: 

9 Make sure that the following users/groups have the following 

permissions: 

• The Administrators group has Full Control permissions. 

• NETWORK SERVICE (in IIS V.6) or ASPNET (in IIS V.5) has 

Read. More details are provided on this subject in the section that 

follows. 

• The desired group (local group or an Active Directory group) has 

Modify, Read & Execute, Read and Write permissions. More 

details are provided on this subject in the section that follows.



63 

Adding the Network Service User 

► To add a network service user: 

1 Right-click the TCWAuth.asmx file at 

C:\Program Files\Orthocrat\TraumaCadServer\Web\Security and 

select Properties from the menu. 

2 In the Security tab, click the Add button. The following window 

appears: 

3 Click the Locations button to display a window similar to the 

following:

64 



4 Select your local computer name and click OK to display the following 

window: 

5 In the Enter the object names to select area, type NETWORK 

SERVICE and click the Check Names button to find the network 

service user locally on the TraumaCad server. It appears all capitalized 

and underlined when it is found. 

NOTE: 

This network service user is found locally on the TraumaCad server and not in 

the Active Directory of the organization.



65 

6 Click OK to return to the TCWAuth.asmx Properties window in which 

you now see that the NETWORK SERVICE user has been added, as 

shown below:

66 



Adding the Active Directory Group 

Add the Active Directory group which specifies the groups of users 

allowed to access the TraumaCad application by clicking the Add button. 

► To add the Active Directory Group: 

1 In the Select Users or Groups window, click the Locations button to 

display a window similar to the following: 

2 Select the location of the Active Directory and click OK. 

3 In the Select Users or Groups window, in the Enter the object names 

to select area, type the name of the Active Directory and click the 

Check Names button. 

4 Once the name appears underlined, it can be assigned the following 

permission by checking the appropriate check boxes: Modify, Read & 

Execute, Read and Write.



67 

5 Select the other user groups in the Group or user name area and click 

the Remove button, so that only the new TraumaCad group, the 

Administrators group and the network service user remain in the 

window (similar to the following).

68 



Testing Security Settings 

► To test that the security settings operate properly: 

1 Log on to a domain computer using a non-authorized user. 

2 Open the TraumaCad home page: 

http:// 

3 When prompted for a user name and password, enter a non-authorized 

user name for the TraumaCad application in the credentials window 

and click OK. The TraumaCad client should not be opened. 

4 Then enter an authorized user name for the TraumaCad application in 

the credentials window and click OK. The TraumaCad client should 

open. 

5 In the TraumaCad audit trail log, which is typically located on the 

TraumaCad server in the C:\Program 

Files\Orthocrat\TraumaCadServer\Logs directory, verify that the 

credentials appear for the user marked in the open TraumaCad.

Scaling X-Rays 


69 

7Chapter 5 


Calibration Spheres – Guidelines on 

Correct Placement 

Introduction 

It is a known fact that there is an inherent magnification factor associated 

with radiographic images. When in a softcopy viewing environment, this 

must be taken into account during the pre-planning of orthopedic 

templating procedures. 

Depending on the radiographic technique and the anatomical area of 

interest, the magnification factor associated with a particular radiograph can 

vary by between 105% - 120% when compared with its true size.

70 



Technique 

In order to correctly calibrate an image, it is necessary to have an object of 

a known dimension in the x-ray beam. This is particularly relevant when 

producing images that require the use of a bucky, for example a pelvis 

x-ray. 

TraumaCad utilizes hollow, precision-engineered, steel spheres of a known 

dimension, which is one inch (25.4mm). Due to the diverging–ray beam, it 

is necessary to place this sphere at the bone level. This is most easily 

achieved for a pelvic x-ray by palpating the greater trochanter and either 

resting the sphere on a suitable foam pad or taping the sphere to the patients 

gown using micropore tape for example. If the patient is large, then it is 

necessary to place the sphere medially for a pelvic x-ray. Due to the effect 

of the soft tissue around the area of the greater trochanter and the diverging 

x-ray beam, the sphere does not always appear within the resultant image. 

When carrying out extremity work, it is not so critical to have a sphere on 

every image as the average magnification factor is 108% (out of bucky and 

the thickness of extremities from patient to patient is less variable). 

TraumaCad enables orthopedic surgeons to compensate for the 

magnification within an image by applying a corresponding magnification 

factor, usually 108%.



71 

The following two figures illustrate the positioning process. 

It is advisable to carry out a simple test to confirm the average oversizing 

required for extremity work: 

► To confirm the average oversizing: 

1 Place the sphere on the CR plate during an extremity examination. For 

example, on a wrist. 

2 Manually measure the sphere within the TraumaCad software and 

check this dimension as a percentage of the true dimension of 25.4mm.

72 




Troubleshooting the TraumaCad Server 


73 

8Chapter 6 

Troubleshooting the 


About This Chapter 

This chapter provides several sections, each of which describes how to 

troubleshoot a different element of the TraumaCad server configuration. 

This chapter contains the following sections: 

• DICOM Connectivity from/to TraumaCad Server, page 74 

• TraumaCad Client Installation, page 75 

• TraumaCad Licensing with Proxy Server, page 78 

• Enabling TraumaCad Logging for Diagnostic Purposes, page 81 

• Templates Issues, page 82 

• Requests for New Templates, page 83 

• Using Medical Tools, page 83 

• Re-signing TraumaCad Prerequisites, page 84 

Existing customers can access the TraumaCad support portal which 

contains additional solutions to various problems. In order to obtain a 

username and password for the Orthocrat support portal, please contact 

TraumaCad support at support@traumacad.com and specify your site name 

in the subject of the email and your contact details in the email’s body. 

You then receive an email containing the support portal link, user name and 

password.

74 



DICOM Connectivity from/to 


In order to check that the TraumaCad server has a valid connection to the 

PACS system, a test can be performed using a Telnet command. 

► To check that the TraumaCad server has a valid 

connection to the PACS: 

1 Open a command line window. 

2 Type: telnet PACS_SERVER_IP PACS_SERVER_PORT, as shown 

below: 

An empty window should be displayed. An example is shown below: 

If a window similar to the one shown below is displayed, verify that the 

PACS details of the TraumaCad configuration are correct and that a 

DICOM node on the PACS was configured with the TraumaCad 

details.



75 

TraumaCad Client Installation 

TraumaCad application (client side) is comprised of two elements: 

• TraumaCad Prerequisites 

• TraumaCad Client application 

The following must be performed before installing the TraumaCad 

application as a client for the first time: 

• Disabling the Internet Explorer Popup Blocker, as described below. 

• Defining the TraumaCad Server Home Page as a Trusted Site, as 

described on page 76. 

Disabling the Internet Explorer 

Popup Blocker 

In order to install the ActiveX component of the TraumaCad server, the 

Internet Explorer popup blocker must be disabled. 

► To disable the Internet Explorer popup blocker: 

1 Open Internet Explorer. 

2 From the Application menu, select Tools and then Pop-up Blocker. 

3 Click Turn Off Pop-up Blocker, as shown below: 

4 Close Internet Explorer and reopen it, in order for this configuration to 

be applied.

76 



Defining the TraumaCad Server 

Home Page as a Trusted Site 

The TraumaCad server home page URL must be placed in the Internet 

Explorer Trusted Sites page. 

► To define the TraumaCad Server as a Trusted Site: 

1 Open Internet Explorer. 

2 From the Application menu, select Tools and then Internet Options. 

3 In the Internet Options window, select the Security tab and then click 

Trusted Sites, as shown below:



77 

4 Click the Sites button to display the Trusted sites window, as shown 

below: 

5 In the Add this website to the zone field, type in the URL of the 

TraumaCad server. Specify the TraumaCad server’s Fully Qualified 

Domain Name (FQDN) and click the Add button. 

6 Approve these entries by clicking OK twice.

78 



TraumaCad Licensing with Proxy 

Server 

TraumaCad client licensing settings are installed, configured and controlled 

from the TraumaCad server. Because of the fact that the TraumaCad system 

is a web system, some steps for troubleshoot licensing issues start with the 

client’s Internet Explorer settings. 

NOTE: 

This is dependent upon the TraumaCad server being up and running and that you 

are able to access it from other PCs at your facility. 

This document assumes that your organization is using a Proxy Server for 

Internet access. In this case, configure Internet Explorer as described below 

in order to facilitate the proxy abilities and limitations on each TraumaCad 

client. 

Use the Bypass proxy server for local address checkbox to eliminate the 

need to access the proxy server routing table for local IP addresses in the 

organization. 

► To access this checkbox: 

1 Close all open Internet Explorer windows. 

2 Right-click the Internet Explorer Desktop icon and choose 

Properties. 

3 Click the Connections tab.



79 

4 Click the LAN Settings button. 

5 Make sure your Proxy server address (FQDN / IP) and port are correct 

and click the Bypass proxy server for local addresses checkbox.

80 



6 Click the Advanced… button and make sure that the TraumaCad 

Server IP address or the IP address’s class A and B (these are the first 

two parts of an IP address) are typed in the Exceptions box. 

7 Click OK three times and reopen TraumaCad client.



81 

Enabling TraumaCad Logging for 

Diagnostic Purposes 

TraumaCad client has built-in logging abilities, which are disabled by 

default. To enable logging, apply the required registry key, as described 

below. 

► To enable the logging capabilities of the TraumaCad 

client: 

1 Close the TraumaCad client, if it is opened. 

2 Open Notepad.exe on the client on which to start logging. 

3 Copy the segment shown below from this document into Notepad: 

Windows Registry Editor Version 5.00 

[HKEY_LOCAL_MACHINE\SOFTWARE\Orthocrat\TraumaCAD] 

"Log"=dword:00000001 

"LogLevel"=dword:0000fffe 

"DicomObjectsLogLevel"="63" 

"LogFolder"="C:\\ClientLogs" 

Notepad should appear as follows: 

Please make sure that the C:\\ClientLogs directory exists on the client 

and change accordingly. 

4 In Notepad, select Save As from the File menu. 

5 Type Enable_TC_log.reg and save the file. 

6 Close Notepad and double-click the file. A message is displayed asking 

you to approve the action.

82 



7 Click OK. 

8 Reboot the TraumaCad client and perform a Query and a Retrieve test. 

9 Once the tests have been completed, navigate to X:\CLIENTLOGS. 

10 Zip all the logs and send them to support@traumacad.com, specifying 

your site name and license number (which can be found in the 

TraumaCad client application in the Help About window) in the subject 

and a detailed message describing the error that you encountered in 

TraumaCad. 

Template Issues 

If one of your surgeons complains that a specific template cannot be found 

on a TraumaCad client, you may view the TraumaCad Server Logs to 

verify that the template was downloaded from TraumaCad properly: 

If this does not rectify the problem, then make a template request to 

TraumaCad’s templates team, as described in the Requests for New 

Templates section on page 83. 

Viewing TraumaCad Server Logs 

This can be done in several ways. The first way to try is to view the event 

log. 

► To view the event log: 

1 Open the TraumaCad Server Control Panel, by navigating to 

http://TRAUMACAD_SERVER_FQDN/TraumaCadServer/ 

ControlPanel and when prompted, enter the valid credentials (to be 

supplied by the PACS administrator ON SITE). 

2 Click the Read Log Files button and click the display 

link in the View column of the row of the latest 

TempaltesUpdateService log file. You should notice towards the end of 

the log that the update process has completed successfully.



83 

Requests for New Templates 

After checking to see that a required template is not available in 

TraumaCad, please access our online form in our support section on our 

website at www.traumacad.com and fill out a template request. This request 

receives a high priority. 

You may also email our support team at support@traumacad.com with the 

following details, in order to create a template request: 

• Account name 

• License number in use (which can be found in your TraumaCad client 

in the Help About window) 

• Contact person on site 

• Templates manufacturer name 

• Template name 

• Procedure 

• Manufacturer Part Number for the requested implant 

In both cases, creating a template may take time and is dependent on 

receiving the manufacturer’s digital files. 

Using Medical Tools 

TraumaCad user’s guide, which describes all the tools that are available in 

the application, is available for download in the support section on our 

website at www.traumacad.com.

84 



Re-signing TraumaCad Prerequisites 

TraumaCad 2.2 uses ClickOnce technology (http://msdn.microsoft.com/ 

en-us/library/t71a733d(VS.80).aspx). In this technology, a small MSI 

component is installed using administrative privileges, while the actual 

application files are installed for restricted users. 

The MSI component must be signed with the TraumaCad server FQDN in 

order for the ClickOnce technology to know from where to download the 

application files. In a standard TraumaCad server installation, the 

TraumaCad server installer uses internal Windows’ API commands to 

determine the server’s FQDN. Should that process fail, the user is prompted 

to provide the server’s FQDN in a window similar to the one described 

below. 

After the proper details are provided, the client-side application can be 

launched successfully. 

If the client application still fails or if an error is encountered on the client 

side, a tool is available that enables the system administrator to re-sign the 

MSI package. This tool is located in the following default path: 

…\TraumaCadServer\Support\ClickOnce\ClientPostInstallation 

Modifier.exe.



85 

After launching the tool, a window similar to the one below is displayed: 

Follow the procedure below to re-sign the MSI package. 

► To re-sign the MSI package: 

1 In the Client Post Installation Updater window, enter values in the 

following fields. 

• Application Manifest Path (.exe manifest file): Click the adjacent 

Browse button, navigate to: C:\Program 

Files\Orthocrat\TraumaCadServer\Web\Main\Deployment\ 

TraumaCadClientVersions\ and select the 

TraumaCad.exe.manifest file.

86 



• Deployment Manifest Path (.application file URL): Click the 

adjacent Browse button, navigate to: C:\Program 

Files\Orthocrat\TraumaCadServer\Web\Main\Deployment\ 

TraumaCadClientVersions and select the 

TraumaCad.application file. 

• URL for Updates: Specify the URL that the client uses to connect 

for downloading the application files. 

• MSI URL: Specify the URL for the MSI package. This URL 

indicates where to search for updates. 

• Alias Name: Specify the TraumaCad client alias name. This 

identifier is used in environments with multiple TraumaCad servers, 

and is shown next to the TraumaCad Start menu item (TraumaCad 

on ). 

2 Click the Run button. 

3 Monitor the Results window for any error messages.

Using SSL 


87 

9Appendix A 

Using SSL 

About This Appendix 

This appendix describes how to configure the usage of SSL with 

TraumaCad and how to verify that it is operating properly. This appendix 

contains the following sections: 

• Configuring SSL, page 88 

• Verifying that SSL is Working, page 96

88 

Using SSL 


Configuring SSL 

► To configure SSL for your website on IIS 6.0 (running on 

Windows Server 2003): 

NOTE: 

Although the screenshots in this appendex show IIS 6.0 on Windows Server 2003, 

the same procedure applies for both IIS 5.0 and IIS 5.1. 

1 Click Start, select All Programs, select Administrative Tools and 

then select Internet Information Services (IIS) Manager. 

2 In Internet Services Manager, in the console tree, expand 

SERVERNAME (your local computer) and then expand Websites. 

3 In the console tree, right-click Default Website and then click 

Properties. 

NOTE: 

It is possible that the site that you have created was stored on a different 

virtual server. If your website is not stored on the default website, right-click 

your own website and click Properties.

Using SSL 


89 

4 In the Default Web Site Properties window, select Directory Security. 

5 In the Directory Security tab, select Server Certificate. 

6 In the Welcome to the Web Server Certificate Wizard, in the Welcome 

page, click Next.

90 

Using SSL 


7 On the Server Certificate page, verify that Create a new certificate is 

selected, and then click Next. 

8 On the Delayed or Immediate Request page, click Send the request 

immediately to an online certification authority and then click Next. 

NOTE: 

You do not have a Certificate Authority (CA) installed on your server or on a 

different server on the network. You can prepare the request, but you must 

manually send it to the CA.

Using SSL 


91 

9 On the Name and Security Settings page, in the Name box, type the 

server’s FQDN and then click Next. 

NOTE: 

A different certificate is required for each website that runs on this server. 

Therefore, make sure to provide the precise server URL. 

! IMPORTANT: 

Internet usage: Make sure that either the Name or the Common Name fields 

(one or both of them) precisely match the external FQDN of the website. For 

example, if your server's NetBIOS name is SERVER1, and it is located in the 

MYINTERNALDOM.LOCAL domain, but it will host a website that will require 

users to enter WWW.KUKU.CO.IL to reach it, then you must use 

WWW.KUKU.CO.IL as the Name or Common Name in the certificate request 

wizard. Do not use SERVER1.MYINTERNALDOM.LOCAL. 

NOTE: 

Intranet usage: For Intranet-only, you can use the internal FQDN of the 

server. For example, if your server's NetBIOS name is SERVER1 and it is 

located in the MYINTERNALDOM.LOCAL domain, you can use 

SERVER1.MYINTERNALDOM.LOCAL for the Name or the Common Name 

fields. 

You can also change the Bit length for the encryption key if you want.

92 

Using SSL 


10 On the Organization Information page, in the Organization box, type 

your own company name. In the Organizational Unit box, type a 

descriptive name and then click Next. 

11 On the Your Sites Common Name page, in the Common name box, 

type the server’s FQDN and then click Next.

Using SSL 


93 

12 On the Geographical Information page, in the State/province box, 

type the required information and then click Next. 

13 On the SSL Port page, in the SSL port this website should use box, 

verify that 443 is specified, and then click Next.

94 

Using SSL 


NOTE: 

SSL can only listen once on port 443. This means that you must either select a 

different SSL port for each SSL-protected website that is hosting on the server, 

or preferably use a different static IP for each site, and share port 443 amongst 

them. 

14 On the Certificate Request Submission page, click Next to submit the 

request, and then click Finish to complete the wizard. 

15 Send your request (*.txt) to your CA. 

16 After you receive a reply open IIS Manager and select Install 

Certificate, direct the installer to the location of the certificate (*.cer) 

and proceed.

Using SSL 


95 

► To use the certificate to secure the website that is using SSL: 

1 In the Default Website Properties window in the Directory Security tab, 

in the Secure communications area in the IIS Manager, click Edit. 

NOTE: 

It is possible that the site that you have created was stored under a different 

virtual server. If your website is not stored on the default website, right-click 

your own website and click Properties. 

NOTE: 

It is also possible that you might not wish to protect the entire website, but 

merely one or two pages within the large website. In fact, this scenario is 

highly probable for most site operators that would only like to protect a few 

important pages, such as an online store or registration form. In that case, you 

do NOT need to SSL-protect the entire site, so do NOT right-click the entire 

site. Right-click only the directory or pages within the site. 

2 In the Secure Communications window, click the Require secure 

channel (SSL) checkbox, click the Require 128-bit encryption 

checkbox and then click OK. 

NOTE: 

Using a requirement of 128-bit encryption should not pose a problem to 

current operation systems and web browsers. Keep in mind though that older 

operation systems may not be able to connect to your site.

96 

Using SSL 


Verifying that SSL is Working 

► To test your new settings: 

1 Open a browser. 

2 Type your server's FQDN (or NetBIOS name, if on the LAN) in the 

address bar (for example: http://server200 for your Intranet, or 

http://www.kuku.co.il for the Internet). 

NOTE: 

Make sure to follow the important notes specified in step #9 on the previous 

pages. 

3 Since you still used HTTP (plain text http, using TCP port 80) the 

following error message will be displayed:

Using SSL 


97 

4 Re-type the URL by using HTTPS instead of HTTP. You should be 

able to view the OWA website. A Security Alert window is displayed. 

Click OK. 

If configured correctly, you will connect to your SSL-protected 

website. 

5 To verify that you are using SSL, find a small yellow lock icon on the 

browser’s lower-right corner . Double-click the lock icon. A 

Certificate window is displayed.

98 

Using SSL 


6 Review the information that is entered into the certificate and click 

OK.

Index 


99 

Index 

A 

Active Directory Group, 68 

Anonymous Access, 60 

Auto-calibration, 49 

Calibration Spheres, 71 

Certificate, 24 

Client 

Installation, 77 

Client 

Preparing, 35 

Client and Network Requirements, 15 

Client Requirements, 15 

Commit, 49 

Configuring 

DICOM Properties, 46 

Logging, 51 

PACS Servers, 44 

Security Settings, 59 

Server, 43 

SSL, 90 

Connectivity, 76 

C 

D 

Default Server Settings, 47 

Default Website, 23 

Diagnostics 

Logging, 82 

Diameter 

Metal Ball, 49 

DICOM, 46 

Local Properties, 46 

DICOM Connectivity, 76 

DICOM Properties, 32 

Download 

Templates, 57 

Downloading Templates, 33 

Fuji, 50 

Getting Started, 11 

F 

G

100 

Index 


Installation 

Client, 77 

Preparing, 16 

Server, 17 

I 

L 

Licensing, 80 

Local DICOM Properties, 46 

Log Files 

Reading, 54 

Logging, 82 

Configuring, 51 

Logs 

Viewing, 84 

Logs Package, 56 

Medical Tools, 85 

Metal Ball, 49, 71 

M 

N 

Network Requirements 

Client, 15 

Network Service User, 65 

PACS Servers 


Popup Blocker, 77 

Port, 23, 45 

Proxy Server 

Licensing, 80 

Proxy Settings, 25 

P 

QR Server, 48 

Q 

R 

Requirements, 13 

Re-signing TraumaCad Prerequisites, 

86 

Resolution, 50 

S 

Scaling X-Rays, 71 

Security Settings 


Testing, 70 

Send Server, 48 

Server, 9 


Default Settings, 47 

Installation, 17 

Logs, 84 

Server Requirements, 13, 14 

Servers 

PACS, 44 

Service Control, 58 

Software Client Requirements, 15 

Software Server Requirements, 14 

SSL 


Verifying, 89, 98 

SSL Certificate, 24 

System Requirements, 13

Index 


101 

T 

TCP Port, 23 

Template 

Downloading, 33, 57 

Issues, 84 

New, 85 

Updating, 34, 57 

Tools 

Medical, 85 

TraumaCad 

Re-signing Prerequisites, 86 

TraumaCad Server, 9 

TraumaCad Workstation Properties, 48 

Troubleshooting, 75 

Trusted Site, 78 

U 

Update 

Templates, 57 

Updating Templates, 34 

V 

Verifying Proper Operation, 33 

Verifying SSL, 98 

Viewing 

Logs, 84 

Website, 23 

Workflow 

Operating, 10 

Setup, 11 

Workstation 

Properties, 48 

X-Rays 

Scaling, 71 

W 

X

102 

Index

TraumaCad Administrator's Guide 2.2 - Final.pdf - Voyant Health

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?