High energy impacts at joint locations often generate highly fragmented, or comminuted, bone fractures. Current approaches for treatment require physicians to decide how to classify the fracture within a hierarchy fracture severity categories. Each category then provides a best-practice treatment scenario to obtain the best possible prognosis for the patient. This article identifies shortcomings associated with qualitative-only evaluation of fracture severity and provides new quantitative metrics that serve to address these shortcomings. We propose a system to semi-automatically extract quantitative metrics that are major indicators of fracture severity. These include: (i) fracture surface area, i.e., how much surface area was generated when the bone broke apart, and (ii) dispersion, i.e., how far the fragments have rotated and translated from their original anatomic positions. This article describes new computational tools to extract these metrics by computationally reconstructing 3D bone anatomy from CT images with a focus on tibial plafond fracture cases where difficult qualitative fracture severity cases are more prevalent. Reconstruction is accomplished within a single system that integrates several novel algorithms that identify, extract and piece-together fractured fragments in a virtual environment. Doing so provides objective quantitative measures for these fracture severity indicators. The availability of such measures provides new tools for fracture severity assessment which may lead to improved fracture treatment. This paper describes the system, the underlying algorithms and the metrics of the reconstruction results by quantitatively analyzing six clinical tibial plafond fracture cases.

中文翻译：

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胫骨粉碎性骨粉碎性骨折的3D重建系统

关节位置的高能量冲击通常会产生高度破碎或粉碎的骨折。当前的治疗方法要求医生决定如何在分级骨折严重程度类别中对骨折进行分类。然后，每个类别都提供最佳实践的治疗方案，以使患者获得最佳的预后。本文指出了与仅对骨折严重程度进行定性评估有关的缺点，并提供了新的定量指标来解决这些缺点。我们提出一种半自动提取定量指标的系统，该指标是骨折严重程度的主要指标。这些因素包括：（i）骨折表面积，即当骨头破裂时产生了多少表面积，以及（ii）分散，即，碎片从原始解剖位置旋转和平移了多远。本文介绍了新的计算工具，可通过从CT图像计算重建3D骨骼解剖结构来提取这些指标，重点是难定性骨折严重性病例更为普遍的胫骨下颌骨折病例。重建是在单个系统中完成的，该系统集成了几种新颖的算法，可在虚拟环境中识别，提取和拼合断裂的碎片。这样做为这些骨折严重性指标提供了客观的量化措施。此类措施的可用性为评估骨折严重程度提供了新的工具，可能会改善骨折的治疗方法。本文介绍了该系统，