{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T09:14:38Z","timestamp":1765444478313,"version":"3.46.0"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"funder":[{"name":"the Top Talent Support Program for young and middle-aged people of Wuxi Health Commottee","award":["HB2023126"],"award-info":[{"award-number":["HB2023126"]}]},{"name":"Wuxi Top Medical Expert Team of \u201cTaihu Talent Program\u201d","award":["TTPJY202112"],"award-info":[{"award-number":["TTPJY202112"]}]},{"name":"Major project of Wuxi health commission","award":["Z202401"],"award-info":[{"award-number":["Z202401"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Health Inf Sci Syst"],"DOI":"10.1007\/s13755-025-00393-z","type":"journal-article","created":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T19:37:44Z","timestamp":1762025864000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A hybrid deep learning approach for accurate diagnosis of tibiofibula open and closed fractures using x-ray images"],"prefix":"10.1007","volume":"13","author":[{"given":"Yapeng","family":"Wang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peng","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junhao","family":"Luo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yunhong","family":"Ma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yongjun","family":"Rui","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yongwei","family":"Wu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,11,1]]},"reference":[{"issue":"11","key":"393_CR1","doi-asserted-by":"publisher","first-page":"e1025","DOI":"10.3928\/01477447-20151020-12","volume":"38","author":"MJ Halawi","year":"2015","unstructured":"Halawi MJ, Morwood MP. Acute management of open fractures: an evidence-based review. Orthopedics. 2015;38(11):e1025-1033. https:\/\/doi.org\/10.3928\/01477447-20151020-12.","journal-title":"Orthopedics"},{"issue":"3","key":"393_CR2","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1089\/sur.2020.075","volume":"22","author":"M Gardezi","year":"2021","unstructured":"Gardezi M, Roque D, Barber D, Spake CSL, Glasser J, Berns E, et al. Wound irrigation in orthopedic open fractures: a review. Surg Infect. 2021;22(3):245\u201352. https:\/\/doi.org\/10.1089\/sur.2020.075.","journal-title":"Surg Infect"},{"issue":"9","key":"393_CR3","doi-asserted-by":"publisher","first-page":"817","DOI":"10.1089\/sur.2022.206","volume":"23","author":"SA Buckman","year":"2022","unstructured":"Buckman SA, Forrester JD, Bessoff KE, Parli SE, Evans HL, Huston JM. Surgical infection society guidelines: 2022 updated guidelines for antibiotic use in open extremity fractures. Surg Infect. 2022;23(9):817\u201328.","journal-title":"Surg Infect"},{"key":"393_CR4","doi-asserted-by":"publisher","first-page":"279","DOI":"10.1016\/j.bjps.2023.04.035","volume":"82","author":"A Sleiwah","year":"2023","unstructured":"Sleiwah A, Patel B, Khan U. Preoperative imaging of open lower limb fractures with CT angiography. J Plast Reconstruct Aesthet Surg. 2023;82:279\u201381. https:\/\/doi.org\/10.1016\/j.bjps.2023.04.035.","journal-title":"J Plast Reconstruct Aesthet Surg"},{"issue":"2","key":"393_CR5","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1302\/2058-5241.5.190025","volume":"5","author":"M Clementson","year":"2020","unstructured":"Clementson M, Bj\u00f6rkman A, Thomsen NOB. Acute scaphoid fractures: guidelines for diagnosis and treatment. EFORT Open Rev. 2020;5(2):96\u2013103.","journal-title":"EFORT Open Rev"},{"issue":"3","key":"393_CR6","doi-asserted-by":"publisher","first-page":"426","DOI":"10.4103\/njms.njms_22_22","volume":"14","author":"A Jose","year":"2023","unstructured":"Jose A, Dandagi S, Chour GV, Bora SP, Dharan MP. Comparative evaluation of post treatment CT scan and clinical parameters in open reduction and closed reduction treatment of condylar fractures. National J Maxillofac Surg. 2023;14(3):426\u201332. https:\/\/doi.org\/10.4103\/njms.njms_22_22.","journal-title":"National J Maxillofac Surg"},{"issue":"5","key":"393_CR7","first-page":"482","volume":"101","author":"K Kamoun","year":"2023","unstructured":"Kamoun K, Ben Chaalia M, Labb\u00e8ne E, Zouari M, Bouaziz M, Jenzri M. MRI contribution in minimally displaced lateral humerus condylar fractures in children. Tunisie Med. 2023;101(5):482\u20135.","journal-title":"Tunisie Med"},{"key":"393_CR8","doi-asserted-by":"publisher","DOI":"10.2106\/jbjs.Oa.22.00030","author":"N Inagaki","year":"2022","unstructured":"Inagaki N, Nakata N, Ichimori S, Udaka J, Mandai A, Saito M. Detection of sacral fractures on radiographs using artificial intelligence. JB JS Open Access. 2022. https:\/\/doi.org\/10.2106\/jbjs.Oa.22.00030.","journal-title":"JB JS Open Access"},{"issue":"10","key":"393_CR9","doi-asserted-by":"publisher","first-page":"879","DOI":"10.1302\/2633-1462.210.Bjo-2021-0133","volume":"2","author":"LOE Carmo","year":"2021","unstructured":"Carmo LOE, van den Merkhof A, Olczak J, Gordon M, Jutte PC, Jaarsma RL, et al. An increasing number of convolutional neural networks for fracture recognition and classification in orthopaedics\u202f: are these externally validated and ready for clinical application? Bone Joint Open. 2021;2(10):879\u201385. https:\/\/doi.org\/10.1302\/2633-1462.210.Bjo-2021-0133.","journal-title":"Bone Joint Open"},{"issue":"2","key":"393_CR10","doi-asserted-by":"publisher","first-page":"1057","DOI":"10.1007\/s00068-022-02136-1","volume":"49","author":"J Prijs","year":"2023","unstructured":"Prijs J, Liao Z, To MS, Verjans J, Jutte PC, Stirler V, et al. Development and external validation of automated detection, classification, and localization of ankle fractures: inside the black box of a convolutional neural network (CNN). Eur J Trauma Emerg Surg: Off Publ Eur Trauma Soc. 2023;49(2):1057\u201369. https:\/\/doi.org\/10.1007\/s00068-022-02136-1.","journal-title":"Eur J Trauma Emerg Surg: Off Publ Eur Trauma Soc"},{"issue":"8","key":"393_CR11","doi-asserted-by":"publisher","first-page":"e0289808","DOI":"10.1371\/journal.pone.0289808","volume":"18","author":"M Magn\u00e9li","year":"2023","unstructured":"Magn\u00e9li M, Ling P, Gisl\u00e9n J, Fagrell J, Demir Y, Arverud ED, et al. Deep learning classification of shoulder fractures on plain radiographs of the humerus, scapula and clavicle. PLoS ONE. 2023;18(8):e0289808. https:\/\/doi.org\/10.1371\/journal.pone.0289808.","journal-title":"PLoS ONE"},{"issue":"2","key":"393_CR12","doi-asserted-by":"publisher","first-page":"317","DOI":"10.1007\/s10140-021-02000-6","volume":"29","author":"M Azuma","year":"2022","unstructured":"Azuma M, Nakada H, Takei M, Nakamura K, Katsuragawa S, Shinkawa N, et al. Detection of acute rib fractures on CT images with convolutional neural networks: effect of location and type of fracture and reader\u2019s experience. Emerg Radiol. 2022;29(2):317\u201328.","journal-title":"Emerg Radiol"},{"issue":"11","key":"393_CR13","doi-asserted-by":"publisher","first-page":"1214","DOI":"10.1177\/17531934231187553","volume":"48","author":"P Atthakomol","year":"2023","unstructured":"Atthakomol P, Thachooprakorn N, Phinyo P, Manosroi W. Open fractures of the hand: a new classification based on risk score to predict infection requiring re-debridement. J Hand Surg Eur Vol. 2023;48(11):1214\u201320.","journal-title":"J Hand Surg Eur Vol"},{"issue":"3","key":"393_CR14","doi-asserted-by":"publisher","first-page":"272","DOI":"10.1177\/00494755241232171","volume":"54","author":"D Chebli","year":"2024","unstructured":"Chebli D, Dhaif F, Ridha A, Schade A, Khatri C. A meta-analysis of the incidence of infections following open tibia fractures and the microorganisms that cause them in high-, middle- and low-income countries. Trop Doct. 2024;54(3):272\u201381.","journal-title":"Trop Doct"},{"issue":"1","key":"393_CR15","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1007\/s00068-014-0485-5","volume":"41","author":"A Hofmann","year":"2015","unstructured":"Hofmann A, Dietz SO, Pairon P, Rommens PM. The role of intramedullary nailing in treatment of open fractures. Eur J Trauma Emerg Surg: Off Publ Eur Trauma Soc. 2015;41(1):39\u201347. https:\/\/doi.org\/10.1007\/s00068-014-0485-5.","journal-title":"Eur J Trauma Emerg Surg: Off Publ Eur Trauma Soc"},{"key":"393_CR16","doi-asserted-by":"publisher","DOI":"10.1016\/j.ebiom.2020.103106","volume":"62","author":"L Jin","year":"2020","unstructured":"Jin L, Yang J, Kuang K, Ni B, Gao Y, Sun Y, et al. Deep-learning-assisted detection and segmentation of rib fractures from CT scans: development and validation of FracNet. EBioMedicine. 2020;62:103106.","journal-title":"EBioMedicine"},{"key":"393_CR17","doi-asserted-by":"publisher","DOI":"10.1038\/nature14539","author":"LC Yann","year":"2015","unstructured":"Yann LC, Yoshua B, Geoffrey H. Deep learning. Nature. 2015. https:\/\/doi.org\/10.1038\/nature14539.","journal-title":"Nature"},{"key":"393_CR18","doi-asserted-by":"crossref","unstructured":"He K, Zhang X, Ren S, Sun J: Deep Residual Learning for Image Recognition. IEEE 2016","DOI":"10.1109\/CVPR.2016.90"},{"key":"393_CR19","unstructured":"Dosovitskiy A, Beyer L, Kolesnikov A, Weissenborn D, Zhai X, Unterthiner T, Dehghani M, Minderer M, Heigold G, Gelly S: An Image is Worth 16x16 Words: Transformers for Image Recognition at Scale. In: International Conference on Learning Representations: 2021; 2021."},{"key":"393_CR20","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1016\/j.media.2017.07.005","volume":"42","author":"G Litjens","year":"2017","unstructured":"Litjens G, Kooi T, Bejnordi BE, Setio AAA, Ciompi F, Ghafoorian M, et al. A survey on deep learning in medical image analysis. Med Image Anal. 2017;42:60\u201388. https:\/\/doi.org\/10.1016\/j.media.2017.07.005.","journal-title":"Med Image Anal"},{"issue":"7639","key":"393_CR21","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1038\/nature21056","volume":"542","author":"A Esteva","year":"2017","unstructured":"Esteva A, Kuprel B, Novoa RA, Ko J, Swetter SM, Blau HM, et al. Dermatologist-level classification of skin cancer with deep neural networks. Nature. 2017;542(7639):115\u20138. https:\/\/doi.org\/10.1038\/nature21056.","journal-title":"Nature"},{"issue":"5","key":"393_CR22","doi-asserted-by":"publisher","DOI":"10.1007\/s42979-021-00782-7","volume":"2","author":"N Hasan","year":"2021","unstructured":"Hasan N, Bao Y, Shawon A, Huang Y. Densenet convolutional neural networks application for predicting COVID-19 using CT image. SN Comput Sci. 2021;2(5):389.","journal-title":"SN Comput Sci"},{"key":"393_CR23","doi-asserted-by":"publisher","unstructured":"Rahman, H, Naik Bukht, TF, Ahmad, R, et al. Efficient breast cancer diagnosis from complex mammographic images using deep convolutional neural network. Comput Intel Neurosc. 2023;2023:7717712. https:\/\/doi.org\/10.1155\/2023\/7717712","DOI":"10.1155\/2023\/7717712"},{"key":"393_CR24","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics12102541","author":"NA Samee","year":"2022","unstructured":"Samee NA, Mahmoud NF, Atteia G, Abdallah HA, Alabdulhafith M, Al-Gaashani M, et al. Classification framework for medical diagnosis of brain tumor with an effective hybrid transfer learning model. Diagnostics (Basel). 2022. https:\/\/doi.org\/10.3390\/diagnostics12102541.","journal-title":"Diagnostics (Basel)"}],"container-title":["Health Information Science and Systems"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s13755-025-00393-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s13755-025-00393-z\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s13755-025-00393-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T09:08:55Z","timestamp":1765444135000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s13755-025-00393-z"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,1]]},"references-count":24,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["393"],"URL":"https:\/\/doi.org\/10.1007\/s13755-025-00393-z","relation":{},"ISSN":["2047-2501"],"issn-type":[{"type":"electronic","value":"2047-2501"}],"subject":[],"published":{"date-parts":[[2025,11,1]]},"assertion":[{"value":"22 June 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 October 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 November 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This study followed the Declaration of Helsinki and was approved by the Ethics Committee of Wuxi No.9 People\u2019s Hospital Affiliated to Soochow University (YXLL2023098).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Not applicable.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}}],"article-number":"73"}}