Predicting Surgical Versus Nonsurgical Management of Acute Isolated Distal Radius Fractures in Patients Under Age 60 Using a Convolutional Neural Network.

Journal: The Journal of hand surgery
Published Date: May 26, 2025

Abstract

PURPOSE: Distal radius fractures (DRFs) represent up to 20% of the fractures in the emergency department. Delays to surgery of more than 14 days are associated with poorer functional outcomes and increased health care utilization/costs. At our institution, the average time to surgery is more than 19 days because of the separation of surgical and nonsurgical care pathways and a lengthy referral process. To address this challenge, we aimed to create a convolutional neural network (CNN) capable of automating DRF x-ray analysis and triaging. We hypothesize that this model will accurately predict whether an acute isolated DRF fracture in a patient under the age of 60 years will be treated surgically or nonsurgically at our institution based on the radiographic input.

Authors

  • Dionne Hsu
    Temerty Faculty of Medicine, University of Toronto, Ontario, Canada.
  • Jonathan Persitz
    Temerty Faculty of Medicine, University of Toronto, Ontario, Canada; Division of Plastic, Reconstructive and Aesthetic Surgery, Department of Surgery, University Health Network, Toronto Western Hand Program, Toronto, Ontario, Canada; Division of Orthopaedic Surgery, Department of Surgery, University Health Network, Toronto, Ontario, Canada.
  • Atefeh Noori
    Division of Plastic, Reconstructive and Aesthetic Surgery, Department of Surgery, University Health Network, Toronto Western Hand Program, Toronto, Ontario, Canada.
  • Haochi Zhang
    DATA Team, University Health Network, Toronto, ON, Canada.
  • Pouria Mashouri
    DATA Team, University Health Network, Toronto, ON, Canada.
  • Rishi Shah
    University Health Network Data Aggregation, Translation and Architecture Team, Toronto, Ontario, Canada.
  • Andrea Chan
    Temerty Faculty of Medicine, University of Toronto, Ontario, Canada; Division of Orthopaedic Surgery, Department of Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada.
  • Amin Madani
    Department of Surgery, Columbia University Irving Medical Center, 161 Fort Washington Avenue, New York, NY 10032, USA.
  • Ryan Paul
    Temerty Faculty of Medicine, University of Toronto, Ontario, Canada; Division of Plastic, Reconstructive and Aesthetic Surgery, Department of Surgery, University Health Network, Toronto Western Hand Program, Toronto, Ontario, Canada; Division of Orthopaedic Surgery, Department of Surgery, University Health Network, Toronto, Ontario, Canada. Electronic address: ryan.paul2@uhn.ca.

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