{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T22:31:25Z","timestamp":1792017085704,"version":"4.4.0"},"reference-count":37,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T00:00:00Z","timestamp":1779753600000},"content-version":"vor","delay-in-days":55,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["esskajournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J. exp. orthop."],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The purpose of this study was to evaluate the diagnostic performance of an artificial intelligence (AI)\u2010based system for the detection of non\u2010displaced femoral neck fractures (FNFs) on plain pelvic radiographs and to assess its potential impact on confirmatory computed tomography (CT) utilization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this retrospective case\u2010control single\u2010centre study, 394 anteroposterior (AP) pelvic radiographs were analysed, including 197 patients with clinically confirmed non\u2010displaced FNFs (Garden I\u2013II) and 197 control radiographs without fracture. Radiological reports and AI outputs were categorized as positive, negative or doubtful. Doubtful findings were analysed separately. Diagnostic accuracy metrics were calculated, and paired comparisons between radiologists and AI were performed using McNemar's test. A secondary analysis evaluated the theoretical potential of AI to reduce confirmatory CT imaging.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The AI software correctly identified 189 of 197 fractures (95.9%) with a false\u2010negative rate of 1.0%, compared with 160 correct detections (81.2%) and a false\u2010negative rate of 7.6% by radiologists. McNemar's test demonstrated significantly fewer missed fractures by the AI software (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Using a combined radiologist\u2013AI decision rule, only two fractures were missed, resulting in a combined miss rate of 1.0%. Among fracture patients undergoing CT, the AI provided a definitive positive result in 94.0% of cases, suggesting a substantial proportion of CT examinations might have served confirmatory purposes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Combined radiologist and AI\u2010assisted assessment in the evaluation of non\u2010displaced FNFs on plain AP pelvic radiographs improves the likelihood of detection and accurate diagnosis. The combined assessment yields the lowest miss rate and may reduce the need for confirmatory CT imaging without compromising patient safety, particularly in emergency settings and during off\u2010hours.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level III.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jeo2.70781","type":"journal-article","created":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T13:13:05Z","timestamp":1779801185000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Artificial intelligence\u2010based diagnosis of non\u2010displaced femoral neck fractures shows excellent sensitivity and specificity and reduces the need for computed tomography scans in emergency rooms"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-0957-2285","authenticated-orcid":false,"given":"Mikhail","family":"Salzmann","sequence":"first","affiliation":[{"name":"Centre of Orthopaedics, Traumatology and Plastic Surgery Brandenburg Medical School, University Hospital Brandenburg an der Havel Brandenburg an der Havel Germany"},{"name":"Faculty of Health Science Brandenburg Brandenburg Medical School Theodor Fontane Brandenburg an der Havel Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle Radharani","family":"Diallo","sequence":"additional","affiliation":[{"name":"Centre of Orthopaedics, Traumatology and Plastic Surgery Brandenburg Medical School, University Hospital Brandenburg an der Havel Brandenburg an der Havel Germany"},{"name":"Faculty of Health Science Brandenburg Brandenburg Medical School Theodor Fontane Brandenburg an der Havel Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Prill","sequence":"additional","affiliation":[{"name":"Centre of Orthopaedics, Traumatology and Plastic Surgery Brandenburg Medical School, University Hospital Brandenburg an der Havel Brandenburg an der Havel Germany"},{"name":"Faculty of Health Science Brandenburg Brandenburg Medical School Theodor Fontane Brandenburg an der Havel Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roland","family":"Becker","sequence":"additional","affiliation":[{"name":"Centre of Orthopaedics, Traumatology and Plastic Surgery Brandenburg Medical School, University Hospital Brandenburg an der Havel Brandenburg an der Havel Germany"},{"name":"Faculty of Health Science Brandenburg Brandenburg Medical School Theodor Fontane Brandenburg an der Havel Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas G.","family":"Schreyer","sequence":"additional","affiliation":[{"name":"Institute for Diagnostic and Interventional Radiology, Brandenburg Medical School Theodor Fontane Brandenburg an\u200ader Havel Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marko","family":"Ostojic","sequence":"additional","affiliation":[{"name":"Sports Traumatology Division, Traumatology Department \u201cDraskoviceva\u201d University Hospital \u201cSisters of Mercy\u201d Zagreb Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolai","family":"Ramadanov","sequence":"additional","affiliation":[{"name":"Centre of Orthopaedics, Traumatology and Plastic Surgery Brandenburg Medical School, University Hospital Brandenburg an der Havel Brandenburg an der Havel Germany"},{"name":"Faculty of Health Science Brandenburg Brandenburg Medical School Theodor Fontane Brandenburg an der Havel Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,26]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics15182300"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2016-014509"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10278-021-00499-2"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare12020125"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.h5527"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2015.11.001"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.2196\/18599"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1080\/17453674.2018.1453714"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13017-015-0049-y"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10140-011-1009-9"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2023.04.010"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-227X-6-4"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13185575"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-004-1627-0"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.107B6.BJJ-2024-1567.R1"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.3391"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2589-7500(19)30123-2"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2005.01.024"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2024.111462"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10278-020-00364-8"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.5435\/JAAOS-D-22-00125"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1080\/17453674.2017.1344459"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1053\/ajem.2002.33007"},{"issue":"1","key":"e_1_2_13_25_1","first-page":"111","article-title":"Traumatic fractures in adults: missed diagnosis on plain radiographs in the emergency department","volume":"89","author":"Pinto A","year":"2018","journal-title":"Acta Biomed"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.5604\/15093492.1220822"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s43465-024-01130-6"},{"key":"e_1_2_13_28_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-025-05888-9"},{"key":"e_1_2_13_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/os.14250"},{"key":"e_1_2_13_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2016.02.020"},{"key":"e_1_2_13_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00113-013-2421-2"},{"key":"e_1_2_13_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/ksa.12362"},{"key":"e_1_2_13_33_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-021-04260-2"},{"key":"e_1_2_13_34_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00256-018-3016-3"},{"key":"e_1_2_13_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2021.11.1362"},{"issue":"6","key":"e_1_2_13_36_1","first-page":"500","article-title":"Meta\u2010analysis of studies on mortality of early surgery vs. delayed surgery for patients with femoral neck fractures [Chinese]","volume":"24","author":"Xu JT","year":"2011","journal-title":"Zhongguo Gu Shang"},{"key":"e_1_2_13_37_1","doi-asserted-by":"publisher","DOI":"10.1080\/17453674.2020.1803664"},{"key":"e_1_2_13_38_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00132-018-03664-8"}],"container-title":["Journal of Experimental Orthopaedics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jeo2.70781","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jeo2.70781","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jeo2.70781","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T18:14:25Z","timestamp":1789841665000},"score":1,"resource":{"primary":{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/10.1002\/jeo2.70781"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4]]},"references-count":37,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1002\/jeo2.70781"],"URL":"https:\/\/doi.org\/10.1002\/jeo2.70781","archive":["Portico"],"relation":{},"ISSN":["2197-1153","2197-1153"],"issn-type":[{"value":"2197-1153","type":"print"},{"value":"2197-1153","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4]]},"assertion":[{"value":"2026-01-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-25","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-26","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70781"}}