Automatic Classification of Traumatic Pelvic Ring Fractures Based On a Rule-Based Regional Radiologic Classification Method

4 pages•Published: January 5, 2026

Roey Ben Yosef, Alona Katzir, Yoram Weil, Rami Mosheiff, Meir Liebergall and Leo Joskowicz

Abstract

Purpose: The Young-Burgess pelvic ring classification system is commonly used to support treatment planning. In the emergency room, it is performed on pelvic AP X-rays using general guidelines, whose results may vary between observers and may not be explainable. We aimed to validate a novel computerized method for the automatic Young-Burgess classification of traumatic pelvic ring fractures on pelvic AP X-rays using a rule-based regional anatomical system that provides systematic and explainable classifications.
Methods: The method inputs a pelvic AP X-ray. It extracts 11 pelvic regions using a pelvic regions atlas and a deep-learning model, classifies each pelvic region as normal/injured with another deep-learning network, and computes the Young-Burgess class with rules that combine the pelvic region classifications. The outputs are the Young-Burgess class and the pelvic AP X-ray with overlayed color-coded pelvic regions.
Evaluation was performed on 564 pelvic AP X-rays classified by a senior orthopedic trauma surgeon, on which 11 pelvic regions were delineated and classified as normal/injured. Two YOLOv8 deep-learning models were trained on 544 pelvic AP X-rays and tested on 20.
Results: Pelvic region computation yielded a mean F1-score of 0.99 (0.98-1.00). Pelvic region classification yielded a specificity of 1.00 and a mean sensitivity of 0.53 (0.20-1.00). The rule-based classification yielded a mean weighted kappa score of 0.47 and AUC score of 0.97.
Conclusion: Automatic Young-Burgess pelvic ring injury classification pelvic on AP X-rays with a rule-based regional anatomical system appears promising. Pelvic region computation is nearly perfect and rule-based classification is also excellent. Pelvic region classification requires further investigation.

Keyphrases: automatic classification, pelvic ap x ray analysis, pelvic ring fractures, young burgess classification

In: Joshua William Giles and Aziliz Guezou-Philippe (editors). Proceedings of The 25th Annual Meeting of the International Society for Computer Assisted Orthopaedic Surgery, vol 8, pages 29-32.

Links:	https://easychair.org/publications/paper/nB2L
	https://doi.org/10.29007/c1bx

BibTeX entry

@inproceedings{CAOS2025:Automatic_Classification_Traumatic_Pelvic,
  author    = {Roey Ben Yosef and Alona Katzir and Yoram Weil and Rami Mosheiff and Meir Liebergall and Leo Joskowicz},
  title     = {Automatic Classification of Traumatic Pelvic Ring Fractures Based On a Rule-Based Regional Radiologic Classification Method},
  booktitle = {Proceedings of The 25th Annual Meeting of the International Society for Computer Assisted Orthopaedic Surgery},
  editor    = {Joshua William Giles and Aziliz Guezou-Philippe},
  series    = {EPiC Series in Health Sciences},
  volume    = {8},
  publisher = {EasyChair},
  bibsource = {EasyChair, https://easychair.org},
  issn      = {2398-5305},
  url       = {/publications/paper/nB2L},
  doi       = {10.29007/c1bx},
  pages     = {29-32},
  year      = {2026}}

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