Association between bone shape and the presence of a fracture in patients with a clinically suspected scaphoid fracture

JOURNAL OF BIOMECHANICS

卷:128

Article

Bevers, Melissa S. A. M.^1,2,3  Wyers, Caroline E.^1,2,4  Daniels, Anne M.^2,5  Audenaert, Emmanuel A.^6,7  van Kuijk, Sander M. J.⁸  van Rietbergen, Bert^3,9  Geusens, Piet P. M. M.^4,10  Kaarsemaker, Sjoerd¹¹  Janzing, Heinrich M. J.⁵  Hannemann, Pascal F. W.¹²  Poeze, Martijn^2,12  van den Bergh, Joop P.^1,2,4,10 

[1] VieCuri Med Ctr, Dept Internal Med, Tegelseweg 210, NL-5912 BL Venlo, Netherlands

[2] Maastricht Univ, Fac Hlth Med & Life Sci, NUTRIM Sch Nutr & Translat Res Metab, Med Ctr, Maastricht, Netherlands

[3] Eindhoven Univ Technol, Dept Biomed Engn, Orthoped Biomech, Eindhoven, Netherlands

[4] Maastricht Univ, Dept Internal Med, Subdiv Rheumatol, Med Ctr, Maastricht, Netherlands

[5] VieCuri Med Ctr, Dept Surg, Venlo, Netherlands

[6] Ghent Univ Hosp, Dept Orthoped Surg & Traumatol, Ghent, Belgium

[7] Univ Antwerp, Dept Electromech, Op3Mech Res Grp, Antwerp, Belgium

[8] Maastricht Univ, Dept Clin Epidemiol & Med Technol Assessment, Med Ctr, Maastricht, Netherlands

[9] Maastricht Univ, Dept Orthoped Surg, Med Ctr, Maastricht, Netherlands

[10] Hasselt Univ, Fac Med & Life Sci, Hasselt, Belgium

[11] VieCuri Med Ctr, Dept Orthoped Surg, Venlo, Netherlands

[12] Maastricht Univ, Dept Surg & Trauma Surg, Med Ctr, Maastricht, Netherlands

关键词: Scaphoid fracture;    Bone shape;    Statistical shape modeling;    High-resolution peripheral quantitative;    computed tomography;   

DOI  :  10.1016/j.jbiomech.2021.110726

来源: Elsevier

【 摘 要 】

Scaphoid fractures are difficult to diagnose with current imaging modalities. It is unknown whether the shape of the scaphoid bone, assessed by statistical shape modeling, can be used to differentiate between fractured and non-fractured bones. Therefore, the aim of this study was to investigate whether the presence of a scaphoid fracture is associated with shape modes of a statistical shape model (SSM). Forty-one high-resolution peripheral quantitative computed tomography (HR-pQCT) scans were available from patients with a clinically suspected scaphoid fracture of whom 15 patients had a scaphoid fracture. The scans showed no motion artefacts affecting bone shape. The scaphoid bones were semi-automatically contoured, and the contours were converted to triangular meshes. The meshes were registered, followed by principal component analysis to determine mean shape and shape modes describing shape variance. The first five out of the forty shape modes cumulatively explained 87.8% of the shape variance. Logistic regression analysis was used to study the association between shape modes and fracture presence. The regression models were used to classify the 41 scaphoid bones as fractured or non-fractured using a cut-off value that maximized the sum of sensitivity and specificity. The classification of the models was compared with fracture diagnosis on HR-pQCT. A regression model with four shape modes had an area under the ROC-curve of 72.3% and correctly classified 75.6% of the scaphoid bones (fractured: 60.0%, non-fractured: 84.6%). To conclude, fracture presence in patients with a clinically suspected scaphoid fracture appears to be associated with the shape of the scaphoid bone.

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