1. A method comprising: receiving pre-operative two dimensional (2D) image data of a reference bone structure and a bone fragment, the reference bone structure including a first set of fiducial markers provided on the reference bone structure, and the bone fragment including a second set of fiducial markers provided on the bone fragment; receiving 3D image data pre-operatively from a 3D imaging sensor; generating a 3D model of the reference bone structure and the bone fragment based on the 3D image data; performing a 2D-3D registration between the pre-operative 2D image data and the 3D model of the reference bone structure and the bone fragment; after manual repositioning of the bone fragment, receiving second 2D image data; performing 2D-2D registration of the first set of fiducial markers and the second set of fiducial markers between the pre-operative 2D image data and the second 2D image data, wherein the performing 2D-2D registration comprises identifying the first set of fiducial markers and the second set of fiducial markers in each of the pre-operative 2D image data and the second 2D image data to determine fiducial marker locations of each of the first set of fiducial markers and the second set of fiducial markers; and determining 3D movement of the bone fragment based at least in part on the 2D-2D registration.