• Koen D Oude Nijhuis, Lente H M Dankelman, Jort P Wiersma, Britt Barvelink, IJpmaFrank F AFFADepartment of Surgery, Groningen, University Medical Centre, Groningen, The Netherlands., VerhofstadMichael H JMHJTrauma Research Unit Department of Surgery, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, Rotterdam, 3000 CA, The Netherlands., Job N Doornberg, Joost W Colaris, WijffelsMathieu M EMMETrauma Research Unit Department of Surgery, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, Rotterdam, 3000 CA, The Netherlands., and Machine Learning Consortium.
• Department of Orthopedic Surgery, Groningen, Groningen University Medical Centre, Groningen, The Netherlands. k.d.oude.nijhuis@umcg.nl.
• Eur J Trauma Emerg Surg. 2024 Jul 9.

PurposeEarly and accurate assessment of distal radius fractures (DRFs) is crucial for optimal prognosis. Identifying fractures likely to lose threshold alignment (instability) in a cast is vital for treatment decisions, yet prediction tools' accuracy and reliability remain challenging. Artificial intelligence (AI), particularly Convolutional Neural Networks (CNNs), can evaluate radiographic images with high performance. This systematic review aims to summarize studies utilizing CNNs to detect, classify, or predict loss of threshold alignment of DRFs.MethodsA literature search was performed according to the PRISMA. Studies were eligible when the use of AI for the detection, classification, or prediction of loss of threshold alignment was analyzed. Quality assessment was done with a modified version of the methodologic index for non-randomized studies (MINORS).ResultsOf the 576 identified studies, 15 were included. On fracture detection, studies reported sensitivity and specificity ranging from 80 to 99% and 73-100%, respectively; the AUC ranged from 0.87 to 0.99; the accuracy varied from 82 to 99%. The accuracy of fracture classification ranged from 60 to 81% and the AUC from 0.59 to 0.84. No studies focused on predicting loss of thresholds alignement of DRFs.ConclusionAI models for DRF detection show promising performance, indicating the potential of algorithms to assist clinicians in the assessment of radiographs. In addition, AI models showed similar performance compared to clinicians. No algorithms for predicting the loss of threshold alignment were identified in our literature search despite the clinical relevance of such algorithms.© 2024. The Author(s).

4 keywords...

hide…