Abstract
BACKGROUND: Femoral neck fractures are a serious health concern, particularly among the elderly. The aim of this study is to diagnose and classify femoral neck fractures from plain pelvic X-rays using deep learning and machine learning algorithms, and to compare the performance of these methods. METHODS: The study was conducted on a total of 598 plain pelvic X-ray images, including 296 patients with femoral neck fractures and 302 individuals without femoral neck fractures. Initially, transfer learning was applied using pre-trained deep learning models: VGG-16, ResNet-50, and MobileNetv2. RESULTS: The pre-trained VGG-16 network demonstrated slightly better performance than ResNet-50 and MobileNetV2 for de-tecting and classifying femoral neck fractures. Using the VGG-16 model, the following results were obtained: 95.6% accuracy, 95.5% sensitivity, 93.3% specificity, 95.7% precision, 95.5% F1 Score, a Cohen's kappa of 0.91, and the Receiver Operating Characteristic (ROC) curve of 0.99. Subsequently, features extracted from the convolution layers of VGG-16 were classified using common machine learning algorithms. Among these, the k-nearest neighbor (k-NN) algorithm outperformed the others and exceeded the accuracy of the VGG-16 model by 1%. CONCLUSION: Successful results were obtained using deep learning and machine learning methods for the detection and clas-sification of femoral neck fractures. The model can be further improved through multi-center studies. The proposed model may be especially useful for physicians working in emergency departments and for those not having sufficient experience in evaluating plain pelvic radiographs.