Abstract:
OBJECTIVES:To develop an accurate machine learning (ML) predictive model incorporating patient, fracture, and trauma characteristics to identify individual patients at risk of an (occult) PMF. METHODS:Databases of 2 studies including patients with TSFs from 2 Level 1 trauma centers were combined for analysis. Using ten-fold cross-validation, 4 supervised ML algorithms were trained in recognizing patterns associated with PMFs: (1) Bayes point machine; (2) support vector machine; (3) neural network; and (4) boosted decision tree. Performance of each ML algorithm was evaluated and compared based on (1) C-statistic; (2) calibration slope and intercept; and (3) Brier score. The best-performing ML algorithm was incorporated into an online open-access prediction tool. RESULTS:Total data set included 263 patients, of which 28% had a PMF. Training of the Bayes point machine resulted in the best-performing prediction model reflected by good C-statistic, calibration slope, calibration intercept, and Brier score of 0.89, 1.02, -0.06, and 0.106, respectively. This prediction model was deployed as an open-access online prediction tool. CONCLUSION:A ML-based prediction model accurately predicted the probability of a (occult) PMF in patients with a TSF based on patient- and fracture-specific characteristics. This prediction model can guide surgeons in their diagnostic workup and preoperative planning. Further research is required to externally validate the model before implementation in clinical practice. LEVEL OF EVIDENCE:Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
journal_name
J Orthop Traumajournal_title
Journal of orthopaedic traumaauthors
Hendrickx LAM,Sobol GL,Langerhuizen DWG,Bulstra AEJ,Hreha J,Sprague S,Sirkin MS,Ring D,Kerkhoffs GMMJ,Jaarsma RL,Doornberg JN,Machine Learning Consortium.doi
10.1097/BOT.0000000000001663subject
Has Abstractpub_date
2020-03-01 00:00:00pages
131-138issue
3eissn
0890-5339issn
1531-2291pii
00005131-202003000-00004journal_volume
34pub_type
杂志文章abstract:OBJECTIVE:The objective of the study was to evaluate functional outcome, patient self-assessment, and radiographic outcome at 1 year in displaced three- and four-part proximal humeral fractures (OTA group 11-B2 and 11-C2). DESIGN:Randomized controlled trial. SETTING:Academic medical center. PATIENTS/PARTICIPANTS:Fif...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,随机对照试验
doi:10.1097/BOT.0b013e31821c2e15
更新日期:2012-02-01 00:00:00
abstract::The current literature tends to favor rigid internal fixation with plates for symptomatic midclavicular nonunions. From 1985 to 1992, 14 patients with clavicular nonunions were treated by open reduction and intramedullary Steinman pin fixation with onlay iliac crest bone grafting. The average age of patients was 36 ye...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199404000-00002
更新日期:1994-01-01 00:00:00
abstract::The Galeazzi fracture-dislocation of the forearm consists of a transverse or short oblique fracture of the radius at the junction of the middle and distal thirds with an associated subluxation or dislocation of the distal radioulnar joint. Anatomic reduction with rigid internal fixation of the radius typically produce...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-198903010-00015
更新日期:1989-01-01 00:00:00
abstract:OBJECTIVE:This study was designed to determine the clinical relevant accuracy of CT-based navigation for drilling. DESIGN:Experimental model. SETTING:Laboratory. METHODS:Twelve drills of varying lengths and diameters were tested with 2 different set-ups. Group 1 used free-hand navigated drilling technique with foam ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:
更新日期:2005-05-01 00:00:00
abstract:OBJECTIVE:The aim of the current study was to see how different interlocking mechanisms would affect construct stability and overall failure in the treatment of two-part surgical neck fractures in the proximal humerus in vitro. METHODS:Left and right bones of eight pairs of fresh-frozen human cadaveric humeri were ass...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3181ffdf9a
更新日期:2011-07-01 00:00:00
abstract:INTRODUCTION:Proximal ulna fractures can cause a significant loss of forearm rotation, elbow stiffness, and disability. The objective of this study was to quantify the loss of forearm rotation after simulated varus and valgus malunions of the proximal ulna. METHODS:Eight cadaveric upper extremities were used to quanti...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e31829f5ebc
更新日期:2014-03-01 00:00:00
abstract:OBJECTIVES:Lateral locked plating for proximal tibial fractures with metaphyseal disruption provides a biomechanically stable and biologically favorable alternative to conventional medial/lateral plate fixation. New polyaxial screw technology incorporates expanding screw bushings, allowing variable angle screw placemen...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/QAI.0b013e3181a25368
更新日期:2009-08-01 00:00:00
abstract:OBJECTIVE:Low-intensity pulsed ultrasound (LIPUS) provides noninvasive therapeutic treatment to accelerate fracture repair and distraction osteogenesis. However, most studies concerning the influence of LIPUS on bone metabolism have been conducted in vivo systems using osteoblastic cells. Therefore, details of the dire...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/01.bot.0000489982.40329.52
更新日期:2016-08-01 00:00:00
abstract:OBJECTIVE:To determine whether knee arthrodesis with simultaneous lengthening using the Ilizarov method for a nonreconstructable knee joint with bone loss and infection is a successful salvage procedure. DESIGN:Retrospective review of patients. SETTING:University hospital-based orthopaedic practice. PATIENTS:From 19...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200503000-00004
更新日期:2005-03-01 00:00:00
abstract:OBJECTIVES:To explore the effect of intramedullary pin size on the biology of a healing fracture, specifically endochondral angiogenesis. We hypothesized that fracture fixation with a smaller pin would permit greater interfragmentary strain resulting in increased total amount of vascular endothelial growth factor withi...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001555
更新日期:2019-10-01 00:00:00
abstract::In an attempt to reduce pin loosening, a flanged external fixator pin has been designed and its bending stiffness has been compared with that of a standard pin. The pins were inserted into pilot holes previously drilled into a piece of teak hardwood. Loads of different magnitudes were applied at a fixed moment arm and...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199502000-00013
更新日期:1995-02-01 00:00:00
abstract::Acute compartment syndrome of the deltoid is rare with only 6 cases reported in the literature. To our knowledge, there are no reported cases of deltoid compartment syndrome after surgery on the shoulder. In this case, the patient developed a tense painful anterior deltoid 3 hours after antegrade nailing of a segmenta...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e318199e83c
更新日期:2009-03-01 00:00:00
abstract:OBJECTIVES:To evaluate the rate of, and reasons for, conversion of closed treatment of humeral shaft fractures using a fracture brace, to surgical intervention. DESIGN:Multicenter, retrospective analysis. SETTING:Nine Level 1 trauma centers across the United States. PATIENTS:A total of 1182 patients with a closed hu...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001666
更新日期:2020-04-01 00:00:00
abstract:OBJECTIVES:To determine whether severe open tibial fractures in children behave like similar fractures in adults. DESIGN AND SETTING:A combined retrospective and prospective review evaluated treatment protocol for type II and type III open tibial fractures in children over a ten-year period from 1984 to 1993. PATIENT...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199707000-00010
更新日期:1997-07-01 00:00:00
abstract:OBJECTIVES:To evaluate the outcomes of treatment with a percutaneous compression plate (PCCP) in stable and unstable intertrochanteric hip fractures. DESIGN:Clinical prospective nonrandomized cohort study. SETTING:San Cecilio University Hospital, Granada (Spain). A tertiary-care hospital. PATIENTS:Patients older tha...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000509
更新日期:2016-06-01 00:00:00
abstract:OBJECTIVES:To analyze long-term functional outcomes in patients with posttraumatic infected tibial nonunions having undergone bone transport with hexapod external fixator. DESIGN:Retrospective cohort study. SETTING:Level 1 trauma center. PATIENTS/PARTICIPANTS:Thirty-eight patients with infected nonunions of the tibi...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001005
更新日期:2018-01-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to evaluate the most appropriate positioning of anatomical locking plates on the distal tibia. METHODS:We positioned 4 types of locking plates (3 straight and 1 bayonet) at anterior, middle, and posterior positions on the medial malleolus on both lower limbs of 15 cadavers. We ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e31827cd67d
更新日期:2013-07-01 00:00:00
abstract::The 2-step closed reduction maneuver was developed to aid in the rarely encountered inferior shoulder dislocation. The maneuver converts the humeral head from an inferior dislocation to an anterior dislocation and then reduces the humeral head into the glenoid. The operator places one hand on the shaft of the humerus ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200605000-00010
更新日期:2006-05-01 00:00:00
abstract::Recent studies on ankle syndesmosis injuries have shown that a significant amount of rotational malediction of the distal fibula are missed and may lead to poor functional outcome. A new set of radiographic criteria were developed to help detect distal fibula internal and external rotation using conventional fluorosco...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e31828f89a9
更新日期:2013-12-01 00:00:00
abstract::A case of open scapulothoracic dissociation with intact neurovascular status in an 8-year-old girl is reported. Scapulothoracic dissociation is a rare injury. Most cases present with significant soft tissue disruption in the shoulder region secondary to separation of the scapula from the thorax, and involve major vasc...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-198802000-00009
更新日期:1988-01-01 00:00:00
abstract:OBJECTIVES:To investigate the incidence of concomitant posterior malleolar fractures (PMFs) in operative, distal-third, spiral tibia fractures. DESIGN:Prospective protocol with retrospective review of data. SETTING:Single, Level 1 trauma center. PATIENTS/PARTICIPANTS:One hundred ninety-three consecutive, skeletally ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001307
更新日期:2018-11-01 00:00:00
abstract::Although opioids are widely used for the management of pain in patients with hip fracture, these medications are known to have a wide range of adverse effects that can result in suboptimal outcomes or serious life-threatening complications. Common opioid-related adverse events include gastrointestinal effects, central...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/BOT.0000000000000563
更新日期:2016-05-01 00:00:00
abstract::A previously developed experimental model for producing nonunions in rats was used to study the biochemical changes of connective tissue parameters in impaired fracture repair. The model is based on rotational instability between the fracture fragments. A mid-diaphyseal femoral osteotomy was performed on 30 male rats ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199602000-00007
更新日期:1996-01-01 00:00:00
abstract:SUMMARY:In the following case, a 20-year-old male was involved in a motorcycle accident where he sustained an open midshaft femur fracture treated with open reduction and internal fixation. Several weeks later, the wound became infected and the plate was removed. Over the following 20 years numerous incision and debrid...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e318051532d
更新日期:2007-05-01 00:00:00
abstract::The use of Ender nails for the treatment of femoral shaft fractures has been described as technically easier and less time consuming than current intramedullary nailing techniques. We reviewed our results with unlocked Ender nails in 26 stable and 17 unstable fracture patterns an average of 3-4 years after injury. Bec...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199209000-00008
更新日期:1992-01-01 00:00:00
abstract::We used a mathematical model to determine whether the approach to derotation of the malrotated femur can be improved for use in corrective osteotomy of the femur. Rotational corrective osteotomy of the femur (RCOF) is a procedure performed by orthopedic surgeons to correct congenital femoral torsion deformities and po...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199806000-00012
更新日期:1998-06-01 00:00:00
abstract:PURPOSE:The purpose of this video is to demonstrate the surgical technique of a shoulder arthrodesis for a patient with multidirectional instability and multiple failed previous surgeries. METHODS:A 25-year-old woman with a long history of left shoulder multidirectional instability in the setting of Ehlers-Danlos synd...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001212
更新日期:2018-08-01 00:00:00
abstract::Monteggia fractures represent approximately 1 to 2 percent of forearm fractures, whereas Galeazzi fractures represent 3 to 6 percent. The combination of these injuries in the same extremity is an exceedingly rare occurrence. We report a case of ipsilateral combination Monteggia and Galeazzi fractures in an adult patie...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200202000-00011
更新日期:2002-02-01 00:00:00
abstract:OBJECTIVES:To compare the hospital costs, charges, and reimbursement for treatment of pediatric femur fractures by two treatment methods: external fixation and 90-90 traction with spica casting. DESIGN:Retrospective clinical review. SETTING:Department of Orthopaedic Surgery, Children's Hospital Oakland, regional pedi...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199811000-00006
更新日期:1998-11-01 00:00:00
abstract::After completing an orthopaedic trauma fellowship, what challenges will you have as regard to maintaining balance and perspective in your new position in society? How will you view yourself, family, and your profession? These are simple suggestions on maintaining passion for your profession. ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/BOT.0000000000000431
更新日期:2015-11-01 00:00:00