The Study Of Six Part Fracture Classification Of Femoral Trochanteric Fracture Based On Computer Technology

Objective: From the perspective of biomechanics to study the biomechanical effect of six part fracture classification of femoral trochanteric fracture.Using finite element method to analyze the stability of each types of six part fracture classification,to provide a further theoretical basis for the stability assessment of each type fracture,so as to provide more effective guidance for the treatment of each types of fractures.Methods: Solicited a healthy adult volunteer,using the CT scan to obtain the DICOM files of any side of the hip,then established the three-dimensional finite element model of each fracture types of six part fracture classification of femoral trochanteric fracture by Mimics17.0,Geomagic Studio 2013,Pro/Engineer 5.0,Hypermesh 13.0 and MSC.Patran/Nastran 2012 software.By setting the material attribute,boundary condition and loading condition,to simulated the stress in the slow gait of the 70 kg human body when standing on a single leg of the femur,the von mises stress distribution nephogram and deformation displacement nephogram of each fracture types of six part fracture classification were obtained.Based on the analysis of the von mises stress distribution,the location of peak value of von mises stress and the total displacement value,the stability characteristics of the each fracture types of six part fracture classification were defined.Results: The von mises stress of the two parts fracture is mainly concentrated in the lesser trochanter,the value is 133 MPa and the average displacement value of the part of femoral head and neck is 6.03 mm.In the three parts fracture(with broken greater trochanter),the von mises stress is mainly concentrated in the greater trochanter,the value is 222 MPa,and the average displacement value of the part of femoral head and neck and the part of greater trochanter is 6.91 mm and 7.11 mm respectively.In the three parts fracture(with broken lesser trochanter),the von mises stress is mainly concentrated in the lesser trochanter,the value is 122 MPa,and the average displacement value of the part of femoral head and neck,the part of lesser trochanter is 7.31 mm,and 4.34 mm respectively.In four parts fracture,the von mises stress is mainly concentrated in greater trochanter,the value is 161 MPa,and the average displacement value of the part of femoral head and neck,the part of greater trochanter and the part of lesser trochanter is 7.87 mm,8.33 mm and 4.66 mm respectively.In five parts fracture(with broken anterolateral wall),the von mises stress is mainly concentrated in greater trochanter,the value is 177 MPa,and the average displacement value of the part of femoral head and neck,the part of greater trochanter,the part of lesser trochanter,and the part of anterolateral wall is 8.22 mm,8.71 mm,4.78 mm,and 4.08 mm respectively.In five parts fracture(with broken posterolateral wall),the von mises stress is mainly concentrated in the lesser trochanter,the value is 130 MPa,and the average displacement value of the part of femoral head and neck,the part of greater trochanter,the part of lesser trochanter,and the part of posterolateral wall is 8.57 mm,8.79 mm,4.73 mm,and 5.22 mm respectively.In six pars fracture,the von mises stress is mainly concentrated in the lesser trochanter,the value is 152 MPa,and the average displacement value of the part of femoral head and neck,the part of greater trochanter,the part of lesser trochanter,the part of anterolateral wall and the part of posterolateral wall is 9.37 mm,9.03 mm,4.88 mm,4.55 mm,and 5.57 mm respectively.The stress concentration sites of different types of fractures are different,mainly in the greater trochanter and the lesser trochanter,and with the increase of the fracture blocks,the average displacement value of fracture blocks of different types of fractures are increases,which is proportional to the trend.Conclusion: The stress distribution,the stress concentration position and stability of each fracture types of six part fracture classification are not the same,the integrity of greater trochanter and lesser trochanter is the important influence factor of stability,stability from high to low: two parts fractures > three parts fractures(greater trochanter rupture)> three parts fractures(lesser trochanter rupture)> four parts fracture > five parts fractures(anterolateral wall rupture)> five part fractures(posterolateral wall rupture)> six part fractures.The two parts fracture is stable fracture type,and the rest are unstable fracture types.Objective: To verify the effectiveness of the computer-aided diagnosis system based on 3D CT images for six part fracture classification of femoral trochanteric fracture,evaluate its clinical application value and discuss the direction of further improvement.Methods: Collected 324 patients with femoral trochanteric fracture which from January 1,2014 to May 31,2016.According to the inclusion criteria and exclusion criteria,107 cases as test data were included in this study.Used the CT workstation,all cases' CT cross-sectional images were performed three-dimensional reconstruction.Then used the cutting function to separate the proximal femur from the acetabulum,and finally stored images derived from the anterior,anterolateral,posterior and posterolateral viewpoint of proximal femur using the camera function.As diagnostic criteria,the fracture type were diagnosed by two orthopedic chief doctor and one chief radiologist according to the six part fracture classification.107 cases were respectively diagnosed by the computer-aided diagnosis system,one orthopedic resident doctor,one orthopedic chief doctor,and the two doctors combined with CAD system respectively.The diagnosis results were recorded for statistical analysis.Results: In 107 cases,the independent diagnostic coincidence rate of CAD was 86.9%,which was lower than that of the orthopedic resident doctor's 94.4%(P>0.05),which was significantly lower than that of the orthopedic chief doctor's 97.2%(P<0.05).After combined with CAD,the diagnostic coincidence rate of the orthopedic resident doctor was increased from 94.4% to 97.2%(P>0.05),and the diagnostic coincidence rate of the orthopedic chief doctor increased from 97.2% to 99.1%(P>0.05).Conclusion: The computer-aided diagnosis system of six part fracture classification of femoral trochanteric fracture based on CT 3D Images can automatically identify CT three-dimensional images and classify the femoral trochanteric fractures with a relatively high accuracy.But it still has shortcomings,which needs further study to improve its clinical application ability.