Abstract: Systems and methods are provided for a continual automatic registration of bone or bone-fragments, instruments, and implants based on only one additional X-ray without the need of changing the position of the X-ray source. A two-dimensional X-ray image is received, which X-ray image shows a surgical region of interest. Artificial intelligence assisted automatic detection and localization of objects such as bone or bone-fragments, tools (e.g., a drill) and/or implants combined with a priori information about the surgical procedure are used to compute their relative three-dimensional positions and orientations at any desired point in time. This registration of the objects can be repeated multiple times and can thus provide guidance in near real time.