Intertrochanteric fracture visualization and analysis using a map projection technique
Understanding intertrochanteric fracture distribution is an important topic in orthopedics due to its high morbidity and mortality. The intertrochanteric fracture can contain high-dimensional information including complicated 3D fracture lines, which often make it difficult to visualize or to obtain valuable statistics for clinical diagnosis and prognosis applications. This paper proposed a map projection technique to map the high-dimensional information into a 2D parametric space. This method can preserve the 3D proximal femur surface and structure while visualizing the entire fracture line with a single plot/view. Using this method and a standardization technique, a total of 100 patients with different ages and genders are studied based on the original radiographs acquired by CT scan. The comparison shows that the proposed map projection representation is more efficient and rich in information visualization than the conventional heat map technique. Using the proposed method, a fracture probability can be obtained at any location in the 2D parametric space, from which the most probable fracture region can be accurately identified. The study shows that age and gender have significant influences on intertrochanteric fracture frequency and fracture line distribution.
KeywordsIntertrochanteric fracture 2D map projection Fracture line visualization Heat map 3D computed tomography
The authors would like to thank the Institutional Ethics Committee of PuRen Hospital for providing the data used in this study. One of the authors, Rong Liu, would like to acknowledge the support from the Wuhan City Health and Family Planning Scientific Research Project (grant no. WX16B21), Hubei Province Health and Family Planning Scientific Research Project (grant nos. WJ2017F032 and WJ2018H0042) and Metallurgical Safety and Health Branch of China Metals Society Health Research Project (grant no. JKWS201620).
- 2.Marsh JL, Slongo TF, Agel J, Broderick JS, Creevey W, a DeCoster T, Prokuski L, Sirkin MS, Ziran B, Henley B, Audigé L (2007) Fracture and dislocation classification compendium - 2007: Orthopaedic trauma association classification, database and outcomes committee. J Orthop Trauma 21:S1–S133CrossRefPubMedGoogle Scholar
- 3.Garden E, RS P (1961) Low angle fixation in fractures of the femoral neck. Surger 101:647Google Scholar
- 4.Shane E, Burr D, Abrahamsen B, Adler RA, Brown TD, Cheung AM, Cosman F, Curtis JR, Dell R, Dempster DW, Ebeling PR, Einhorn TA, Genant HK, Geusens P, Klaushofer K, Lane JM, McKiernan F, McKinney R, Ng A, Nieves J, O’Keefe R, Papapoulos S, Sen Howe T, Van Der Meulen MCH, Weinstein RS, Whyte MP (2014) Atypical subtrochanteric and diaphyseal femoral fractures: second report of a task force of the American society for bone and mineral research. J Bone Miner Res 29:1–23CrossRefPubMedGoogle Scholar
- 10.Misir A, Ozturk K, Kizkapan TB, Yildiz KI, Gur V, Sevencan A (2018) Fracture lines and comminution zones in OTA/AO type 23C3 distal radius fractures: The distal radius map. J Orthop Surg 26Google Scholar
- 14.Nyrtsov MV (2003) The classification of projections of irregularly-shaped celestial bodies. Proc 21st Int Cartogr Conf:1158–1164Google Scholar
- 15.Yang Q, Snyder J, Tobler W (1999) Map Projection Transformation: Principles and Applications, CRC PressGoogle Scholar
- 16.Standring S (2016) Gray’s Anatomy 41thGoogle Scholar
- 19.Haidukewych GJ, a Israel T, Berry DJ (2001) Reverse obliquity fractures of the intertrochanteric region of the femur. J Bone Joint Surg Am 83–A:643–650Google Scholar
- 24.Tanner DA, Kloseck M, Crilly RG, Chesworth B, Gilliland J (2010) Hip fracture types in men and women change differently with age. BMCGeriatr 10:12Google Scholar
- 25.Melton LJ 3rd, Ilstrup DM, Riggs BL, Beckenbaugh RD (1982) Fifty-year trend in hip fracture incidence, Clin Orthop. 144–149Google Scholar
- 27.Nevitt MC, Curnrnings SR (1993) Type of Fall and Risk of Hip and Wrist fractures: the study of osteoporotic fractures 1226–1234Google Scholar