Invisible Yet Detected: PelFANet with Attention-Guided Anatomical Fusion for Pelvic Fracture Diagnosis

Pelvic fractures pose significant diagnostic challenges, particularly in cases where fracture signs are subtle or invisible on standard radiographs. To address this, we introduce PelFANet, a dual-stream attention network that fuses raw pelvic X-rays with segmented bone images to improve fracture classification. The network em-ploys Fused Attention Blocks (FABlocks) to iteratively exchange and refine fea-tures from both inputs, capturing global context and localized anatomical detail. Trained in a two-stage pipeline with a segmentation-guided approach, PelFANet demonstrates superior performance over conventional methods. On the AMERI dataset, it achieves 88.68% accuracy and 0.9334 AUC on visible fractures, while generalizing effectively to invisible fracture cases with 82.29% accuracy and 0.8688 AUC, despite not being trained on them. These results highlight the clini-cal potential of anatomy-aware dual-input architectures for robust fracture detec-tion, especially in scenarios with subtle radiographic presentations.