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Morphometry and Density Analysis of the Fifth Metacarpal by Amrita Unnikumaran a Thesis Submitted in Partial Fulfillment Of

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Morphometry and Density Analysis of the Fifth Metacarpal by Amrita Unnikumaran a Thesis Submitted in Partial Fulfillment Of Morphometry and Density Analysis of the Fifth Metacarpal by Amrita Unnikumaran A thesis submitted in partial fulfillment of the requirements for the degree of Master of Science in Biomedical Engineering Department of Medical Engineering College of Engineering University of South Florida Co-Major Professor: William E. Lee III, Ph.D. Co-Major Professor: Peter Simon, Ph.D. Robert Frisina, Ph.D. Sergio Gutierrez, Ph.D. Date of Approval: October 25, 2019 Keywords: Bone Geometry, Bone Density, Computerized Tomography Scan Study, Sexual Dimorphism Copyright © 2019, Amrita Unnikumaran Dedication I dedicate this work to my family for their immense support and encouragement. Acknowledgments I would like to express my sincere gratitude to my mentor Dr. Peter Simon and Dr. William Lee for their guidance and motivation which helped me succeed. I very grateful to Dr. Robert Frisina and Dr. Sergio Gutirezz for their valuable time and suggestions which kept me motivated. I would also like to extend my gratitude to University of South Florida and Foundation for Orthopaedic Research and Education for giving me the opportunity to learn and experience high quality research. Table of Contents List of Tables ................................................................................................................................... iii List of Figures ................................................................................................................................... v Abstract .......................................................................................................................................... vii Chapter 1: Introduction .................................................................................................................. 1 1.1 Study Motivation .......................................................................................................... 1 1.2 Study Aims and Objectives ........................................................................................... 2 1.3 General Limitations ....................................................................................................... 4 Chapter 2: Background ................................................................................................................... 5 2.1 Fifth Metacarpal ............................................................................................................ 5 2.2 Ligaments and Other Associated Structures ................................................................ 6 2.3 Fractures of Fifth Metacarpal Bones ............................................................................ 7 2.4 Current Methods of Diagnosis ...................................................................................... 8 2.5 Current Methods for Treatment of Metacarpal Fractures ........................................... 9 2.5.1 Nonsurgical Treatment .................................................................................. 9 2.5.2 Surgical Treatment ......................................................................................... 9 2.6 Previous Morphometry Studies ................................................................................. 11 Chapter 3: Methodology for Morphometry and Density Analysis of the Fifth Metacarpal ......... 15 3.1 Study Population ......................................................................................................... 15 3.2 Methodology ............................................................................................................... 15 3.2.1 Segmentation ............................................................................................... 16 3.2.2 Coordinate System and Alignment .............................................................. 17 3.2.3 Normalization............................................................................................... 18 3.2.4 Measurements ............................................................................................. 19 3.2.5 Inscribed and Circumscribed Circles Calculation ......................................... 20 3.2.5.1 The Efficiency of the Algorithm .................................................... 24 3.2.6 Density Analysis ........................................................................................... 25 3.3 Statistical Analysis ....................................................................................................... 28 Chapter 4: Results and Discussions .............................................................................................. 29 4.1 Results ......................................................................................................................... 29 i 4.2 Discussions .................................................................................................................. 40 Chapter 5: Conclusion and Recommendations ............................................................................ 42 5.1 Implication of Results .................................................................................................. 42 5.2 Future Work and Recommendations .......................................................................... 43 References .................................................................................................................................... 45 Appendix A: Table of Results ........................................................................................................ 48 Appendix B: Statistical Analysis from SAS ..................................................................................... 54 Appendix C: Results from Previous Studies .................................................................................. 59 Appendix D: Table of Terminology ............................................................................................... 63 Appendix E: Copyright Permissions .............................................................................................. 64 ii List of Tables Table 1: Average Length of Bone as a Function of Height of the Specimen Donor ........... 30 Table 2: Average Diameter of Inscribed Circle for Canal .................................................... 30 Table 3: Average Diameter of Circumscribed Circle for Canal ........................................... 31 Table 4: Average Diameter of Inscribed Circle for Whole Bone Model ............................. 31 Table 5: Average Diameter of Circumscribed Circle for Whole Bone Model ..................... 32 Table 6: Two-Sample t-Test Assuming Unequal Variances for Canal Circumscribed Circles .................................................................................................................... 32 Table 7: Two-Sample t-Test Assuming Unequal Variances for Canal Inscribed Circles .................................................................................................................... 33 Table 8: Two-Sample t-Test Assuming Unequal Variances for Inscribed Circles of Whole Bone ........................................................................................................... 33 Table 9: Two-Sample t-Test Assuming Unequal Variances for Circumscribed Circles for Whole Bone ..................................................................................................... 33 Table 10: Region and Zone-wise Distribution of Density in Male and Female .................... 37 Table A1: Results of Minimum Values of Scribed Circles...................................................... 48 Table A2: Results of Density Distribution, Part 1 .................................................................. 50 Table A3: Results of Density Distribution, Part 2 .................................................................. 52 iii Table C1: Details of Existing Sizes of Headless Screws ......................................................... 59 Table C2: Details of existing sizes of Headed Cannulated Screws ........................................ 61 Table C3: Results from the Study of Michael Rivlin et al ...................................................... 62 Table D1: Table of Terminology Used in the Methodology of Chapter 3 ............................. 63 iv List of Figures Figure 1: 3D model of hand (right anatomical side) from MIMICS (Materialize, Leuven, Belgium) ............................................................................... 6 Figure 2: Image processed for the fifth metacarpal bone from CT scan ............................. 16 Figure 3: The image from MIMICS ....................................................................................... 18 Figure 4: The solid model of fifth metacarpal after orthogonal transformation ................ 20 Figure 5a: The bone model with the circumscribed circle around solid HU model, and circumscribed circle around the canal HU model ................................................. 21 Figure 5b: The cross-section of the 3D scribed circles drawn around the two models in possible combinations .......................................................................................... 21 Figure 6a: The cross-section of the solid HU model with the circumscribed circle and canal PC model with the inscribed circle ............................................................. 22 Figure 6b: The cross-section of the solid PC model with inscribed circle and canal HU model with circumscribed circle ..........................................................................
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