Cloud-Based Three-Dimensional Pattern Analysis and Classification of Proximal Humeral Fractures – A Feasibility Study

For the complex clinical issue of treatment decision for proximal humeral fractures, dedicated software based on three-dimensional (3D) computer tomography (CT) models would potentially allow for a more accurate fracture classification and help to plan the surgical strategy needed to reduce the fracture in the operating theatre. The aim of this study was to elaborate the feasibility of implementation of such software using state-of-the-art cloud technology to enable access to its functionalities in a distributed manner. Feasibility was studied by implementation of a prototype application, which was tested in a usability study with five biomedical engineers.Implementation of a cloud-based solution was feasible using state-of-the-art technology under application of a specific software architectural approach allowing to distribute computational load between client and server. Mean System Usability Scale (SUS) Score for the developed application was determined to be 63 (StDev 20.4). These results can be interpreted as a medium low usability with high standard deviation of the measured SUS score. We conclude that more test subjects should be included in future studies and the developed application should be evaluated with a representative user group such as orthopaedic shoulder surgeons in a clinical setting.