{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T17:59:42Z","timestamp":1777744782290,"version":"3.51.4"},"reference-count":34,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,4,3]],"date-time":"2025-04-03T00:00:00Z","timestamp":1743638400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Distal radius fractures account for 12%\u201317% of all fractures, with accurate classification being crucial for proper treatment planning. Studies have shown that in emergency settings, the misdiagnosis rate of hand\/wrist fractures can reach up to 29%, particularly among non\u2010specialist physicians due to a high workload and limited experience. While existing AI methods can detect fractures, they typically require large training datasets and are limited to fracture detection without type classification. Therefore, there is an urgent need for an efficient and accurate method that can both detect and classify different types of distal radius fractures. To develop and validate an intelligent classifier for distal radius fractures by combining a statistical shape model (SSM) with a neural network (NN) based on CT imaging data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>From August 2022 to May 2023, a total of 80 CT scans were collected, including 43 normal radial bones and 37 distal radius fractures (17 Colles', 12 Barton's, and 8 Smith's fractures). We established the distal radius SSM by combining mean values with PCA (Principal Component Analysis) features and proposed six morphological indicators across four groups. The intelligent classifier (SSM\u2009+\u2009NN) was trained using SSM features as input data and different fracture types as output data. Four\u2010fold cross\u2010validations were performed to verify the classifier's robustness. The SSMs for both normal and fractured distal radius were successfully established based on CT data. Analysis of variance revealed significant differences in all six morphological indicators among groups (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). The intelligent classifier achieved optimal performance when using the first 15 PCA\u2010extracted features, with a cumulative variance contribution rate exceeding 75%. The classifier demonstrated excellent discrimination capability with a mean area under the curve (AUC) of 0.95 in four\u2010fold cross\u2010validation, and achieved an overall classification accuracy of 97.5% in the test set. The optimal prediction threshold range was determined to be 0.2\u20130.4.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The SSMs for both normal and fractured distal radius were successfully established based on CT data. Analysis of variance revealed significant differences in all six morphological indicators among groups (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). The intelligent classifier achieved optimal performance when using the first 15 PCA\u2010extracted features, with a cumulative variance contribution rate exceeding 75%. The classifier demonstrated excellent discrimination capability with a mean AUC of 0.95 in four\u2010fold cross\u2010validation and achieved an overall classification accuracy of 97.5% in the test set. The optimal prediction threshold range was determined to be 0.2\u20130.4.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The CT\u2010based SSM\u2009+\u2009NN intelligent classifier demonstrated excellent performance in identifying and classifying different types of distal radius fractures. This novel approach provides an efficient, accurate, and automated tool for clinical fracture diagnosis, which could potentially improve diagnostic efficiency and treatment planning in orthopedic practice.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.70034","type":"journal-article","created":{"date-parts":[[2025,4,5]],"date-time":"2025-04-05T07:16:25Z","timestamp":1743837385000},"page":"1513-1524","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A Neural Network Model for Intelligent Classification of Distal Radius Fractures Using Statistical Shape Model Extraction Features"],"prefix":"10.1111","volume":"17","author":[{"given":"Xing\u2010bo","family":"Cai","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology  Kunming Yunnan China"},{"name":"The Key Laboratory of Digital Orthopaedics of Yunnan Province  Kunming Yunnan China"},{"name":"Department of Orthopedics 920th Hospital of Joint Logistics Support Force, PLA  Kunming China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ze\u2010hui","family":"Lu","sequence":"additional","affiliation":[{"name":"The Faculty of Medicine, Nursing, and Health Sciences, Monash University  Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhi","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology  Kunming Yunnan China"},{"name":"The Key Laboratory of Digital Orthopaedics of Yunnan Province  Kunming Yunnan China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yong\u2010qing","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Orthopedics 920th Hospital of Joint Logistics Support Force, PLA  Kunming China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun\u2010shen","family":"Huang","sequence":"additional","affiliation":[{"name":"Key Lab of Statistical Modeling and Data Analysis of Yunnan, Yunnan University  Kunming China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hao\u2010tian","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology  Kunming Yunnan China"},{"name":"The Key Laboratory of Digital Orthopaedics of Yunnan Province  Kunming Yunnan China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhong\u2010qi","family":"Lou","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology  Kunming Yunnan China"},{"name":"The Key Laboratory of Digital Orthopaedics of Yunnan Province  Kunming Yunnan China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zi\u2010qi","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology  Kunming Yunnan China"},{"name":"The Key Laboratory of Digital Orthopaedics of Yunnan Province  Kunming Yunnan China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhang\u2010cong","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology  Kunming Yunnan China"},{"name":"The Key Laboratory of Digital Orthopaedics of Yunnan Province  Kunming Yunnan China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiong\u2010gang","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology  Kunming Yunnan China"},{"name":"The Key Laboratory of Digital Orthopaedics of Yunnan Province  Kunming Yunnan China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying","family":"Wu","sequence":"additional","affiliation":[{"name":"Key Lab of Statistical Modeling and Data Analysis of Yunnan, Yunnan University  Kunming China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-2500-3926","authenticated-orcid":false,"given":"Sheng","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology  Kunming Yunnan China"},{"name":"The Key Laboratory of Digital Orthopaedics of Yunnan Province  Kunming Yunnan China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,4,3]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.media.2009.05.004"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11914-021-00711-w"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1098\/rsta.2015.0202"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/jor.25227"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-020-05444-7"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/joa.13552"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/CORR.0000000000000848"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1080\/17453674.2019.1711323"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1080\/17453674.2020.1837420"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10278\u2010022\u201000741\u20105"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41746-019-0105-1"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-019-06167-y"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-021-25779-x"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1080\/17453674.2018.1453714"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2022.110366"},{"key":"e_1_2_13_17_1","doi-asserted-by":"crossref","first-page":"1285","DOI":"10.3390\/s22031285","article-title":"Fracture Detection in Wrist X\u2010Ray Images Using Deep Learning\u2010Based Object Detection Models","volume":"22","author":"Hardala\u00e7 F.","year":"2022","journal-title":"Sensors"},{"key":"e_1_2_13_18_1","doi-asserted-by":"crossref","first-page":"6006","DOI":"10.1038\/s41598-021-85570-2","article-title":"Critical Evaluation of Deep Neural Networks for Wrist Fracture Detection","volume":"11","author":"Raisuddin A. M.","year":"2021","journal-title":"Scientific Reports"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cub.2019.02.034"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10916-018-1088-1"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2018180547"},{"key":"e_1_2_13_22_1","doi-asserted-by":"crossref","first-page":"694","DOI":"10.1186\/s13018-021-02845-0","article-title":"Artificial Intelligence to Diagnosis Distal Radius Fracture Using Biplane Plain X\u2010Rays","volume":"16","author":"Oka K.","year":"2021","journal-title":"Journal of Orthopaedic Surgery and Research"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10278-021-00519-1"},{"key":"e_1_2_13_24_1","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1016\/j.jhsa.2020.02.008","article-title":"Distal Radius Malunion","volume":"45","author":"Katt B.","year":"2020","journal-title":"Journal of Hand Surgery"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00256-016-2350-6"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2020.5672"},{"key":"e_1_2_13_27_1","doi-asserted-by":"crossref","first-page":"562","DOI":"10.11622\/smedj.2015130","article-title":"Morphology of Distal Radius Curvatures: A CT\u2010Based Study on the Malaysian Malay Population","volume":"56","author":"Singh T. S. P.","year":"2015","journal-title":"Singapore Medical Journal"},{"key":"e_1_2_13_28_1","doi-asserted-by":"publisher","DOI":"10.1080\/13814788.2019.1625886"},{"key":"e_1_2_13_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hcl.2005.03.002"},{"key":"e_1_2_13_30_1","doi-asserted-by":"publisher","DOI":"10.1259\/bjr.20150914"},{"key":"e_1_2_13_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/0262-8856(92)90066-C"},{"key":"e_1_2_13_32_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12880-017-0193-9"},{"key":"e_1_2_13_33_1","doi-asserted-by":"publisher","DOI":"10.1080\/17453674.2019.1600125"},{"key":"e_1_2_13_34_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13246\u2010023\u201001261\u20104"},{"key":"e_1_2_13_35_1","doi-asserted-by":"publisher","DOI":"10.1097\/CORR.0000000000002385"}],"container-title":["Orthopaedic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/os.70034","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,5]],"date-time":"2025-05-05T03:09:48Z","timestamp":1746414588000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/os.70034"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,3]]},"references-count":34,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,5]]}},"alternative-id":["10.1111\/os.70034"],"URL":"https:\/\/doi.org\/10.1111\/os.70034","archive":["Portico"],"relation":{},"ISSN":["1757-7853","1757-7861"],"issn-type":[{"value":"1757-7853","type":"print"},{"value":"1757-7861","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,3]]},"assertion":[{"value":"2024-07-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-12","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-04-03","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}