Skip to main content
SpringerLink
Log in

Intertrochanteric fracture visualization and analysis using a map projection technique

  • Original Article
  • Published:
Medical & Biological Engineering & Computing Aims and scope Submit manuscript

Abstract

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.

Generation of 2D parametric map for intertrochanteric fracture probability visualization.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8

Similar content being viewed by others

References

  1. Mears SC (2014) Classification and surgical approaches to hip fractures for nonsurgeons. Clin Geriatr Med 30:229–241

    Article  PubMed  Google Scholar 

  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–S133

    Article  PubMed  CAS  Google Scholar 

  3. Garden E, RS P (1961) Low angle fixation in fractures of the femoral neck. Surger 101:647

    Google 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 29:1–23

    Article  PubMed  Google Scholar 

  5. Ahn J, Bernstein J (2010) Fractures in brief; intertrochanteric hip fractures. Clin Orthop Relat Res 468:1450–1452

    Article  PubMed  PubMed Central  Google Scholar 

  6. Mundi S, Pindiprolu B, Simunovic N, Bhandari M (2014) Similar mortality rates in hip fracture patients over the past 31 years. Acta Orthop 85:54–59

    Article  PubMed  PubMed Central  Google Scholar 

  7. Cole PA, Mehrle RK, Bhandari M, Zlowodzki M (2013) The Pilon map: fracture lines and comminution zones in OTA/AO type 43C3 Pilon fractures. J Orthop Trauma 27:e152–e156

    Article  PubMed  Google Scholar 

  8. Molenaars RJ, Mellema JJ, Doornberg JN, Kloen P (2015) Tibial plateau fracture characteristics: computed tomography mapping of lateral, medial, and bicondylar fractures. J Bone Jt Surg - Am Vol 97:1512–1520

    Article  Google Scholar 

  9. Lubovsky O, Kreder M, Wright DA, Kiss A, Gallant A, Kreder HJ, Whyne CM (2013) Quantitative measures of damage to subchondral bone are associated with functional outcome following treatment of displaced acetabular fractures. J Orthop Res 31:1980–1985

    Article  PubMed  Google 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 26

  11. Armitage BM, Wijdicks CA, Tarkin IS, Schroder LK, Marek DJ, Zlowodzki M, Cole PA (2009) Mapping of scapular fractures with three-dimensional computed tomography. J Bone Jt Surg - Ser A 91:2222–2228

    Article  Google Scholar 

  12. Mellema JJ, Eygendaal D, van Dijk CN, Ring D, Doornberg JN (2016) Fracture mapping of displaced partial articular fractures of the radial head. J Shoulder Elb Surg 25:1509–1516

    Article  Google Scholar 

  13. Sendra GH, Hoerth CH, Wunder C, Lorenz H (2015) 2D map projections for visualization and quantitative analysis of 3D fluorescence micrographs. Sci Rep 5:1–6

    Article  Google Scholar 

  14. Nyrtsov MV (2003) The classification of projections of irregularly-shaped celestial bodies. Proc 21st Int Cartogr Conf:1158–1164

  15. Yang Q, Snyder J, Tobler W (1999) Map Projection Transformation: Principles and Applications, CRC Press

  16. Standring S (2016) Gray’s Anatomy 41th

  17. Williams SE, Linton NWF, Niederer S, O’Neill MD (2017) Simultaneous display of multiple three-dimensional electrophysiological datasets (dot mapping). Europace 19:1743–1749

    Article  PubMed  Google Scholar 

  18. Jensen JS (1980) Classification of trochanteric fractures. Acta Orthop 51:803–810

    Article  CAS  Google 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:643–650

  20. Fox KM, Cummings SR, Williams E, Stone K (2000) International original article femoral neck and intertrochanteric fractures have different risk factors : a prospective study. Osteoporos Int 11:1018–1023

    Article  PubMed  CAS  Google Scholar 

  21. Karagas MR, Lu-Yao GL, Barrett JA, Beach ML, Baron JA (1996) Heterogeneity of hip fracture: age, race, sex, and geographic patterns of femoral neck and trochanteric fractures among the US elderly. Am J Epidemiol 143:677–682

    Article  PubMed  CAS  Google Scholar 

  22. Gullberg B, Johnell O, Kanis JA (1997) International original article world-wide projections for hip fracture. Osteoporos Int 44:407–413

    Article  Google Scholar 

  23. Bjørgul K, Reikerås O (2007) Incidence of hip fracture in southeastern Norway: a study of 1,730 cervical and trochanteric fractures. Int Orthop 31:665–669

    Article  PubMed  Google 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 10:12

    Google Scholar 

  25. Melton LJ 3rd, Ilstrup DM, Riggs BL, Beckenbaugh RD (1982) Fifty-year trend in hip fracture incidence, Clin Orthop. 144–149

  26. Beauchet O, Annweiler C, Allali G, Berrut G, Herrmann FR, Dubost V (2008) Recurrent falls and dual task-related decrease in walking speed: is there a relationship? J Am Geriatr Soc 56:1265–1269

    Article  PubMed  Google Scholar 

  27. Nevitt MC, Curnrnings SR (1993) Type of Fall and Risk of Hip and Wrist fractures: the study of osteoporotic fractures 1226–1234

  28. Ford CM, Keaveny TM, Hayes WC (1996) The effect of impact direction on the structural capacity of the proximal femur during falls. J Bone Miner Res 11:377–383

    Article  PubMed  CAS  Google Scholar 

  29. Chen PH, Wu CC, Tseng YC, Fan KF, Lee PC, Chen WJ (2012) Comparison of elderly patients with and without intertrochanteric fractures and the factors affecting fracture severity. Formos J Musculoskelet Disord 3:61–65

    Article  Google Scholar 

  30. Lotz JC, Cheal EJ, Hayes WC (1995) Stress distributions within the proximal femur during gait and falls: implications for osteoporotic fracture. Osteoporos Int 5:252–261

    Article  PubMed  CAS  Google Scholar 

  31. Brown TD, Ferguson AB (1980) Mechanical property distributions in the cancellous bone of the human proximal femur. Acta Orthop 51:429–437

    Article  CAS  Google Scholar 

  32. Martens M, Van Audekercke R, Delport P, De Meester P, Mulier JC (1983) The mechanical characteristics of cancellous bone at the upper femoral region. J Biomech 16:971–983

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgements

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).

Author information

Author notes

  1. Yucheng Fu and Rong Liu contributed equally to this work.

Authors and Affiliations

  1. Nuclear Engineering Program, Mechanical Engineering Department, Virginia Tech, 635 Prices Fork Road, Blacksburg, VA, 24061, USA

    Yucheng Fu, Rong Liu & Yang Liu

  2. Department of Orthopadics, PuRen Hospital Affiliated with Wuhan University of Science and Technology, No.1 Benxi Road, Qingshan District, 430080, Hubei Province, China

    Rong Liu

  3. Department of Orthopadics, First Affiliated Hospital, Dalian Medical University, Dalian, 116044, China

    Jiawei Lu

Authors
  1. Yucheng Fu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Rong Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yang Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jiawei Lu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yang Liu.

Electronic supplementary material

Fig. A.1

Proximal femur fracture distribution for three age groups: (a) 30–50 years old, (b) 50–70 years old and (c) 70–100 years old, using the four anatomical views (DOCX 2.38 mb)

Fig. A.2

Proximal femur fracture distribution for two gender groups: (a) males, (b) females, using the four anatomical views (DOCX 1.63 mb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Fu, Y., Liu, R., Liu, Y. et al. Intertrochanteric fracture visualization and analysis using a map projection technique. Med Biol Eng Comput 57, 633–642 (2019). https://doi.org/10.1007/s11517-018-1905-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11517-018-1905-1

Keywords

Search

Navigation