Noninvasive Quantitative Assessment of Bone Healing after Distraction Osteogenesis

Abstract

One of the greatest challenges of limb lengthening and deformity correction is deciding when the bone has healed enough to remove the external fixator. Standard radiography is the most common imaging method used to assess bone healing after distraction osteogenesis because it is widely available, cheap, and relatively safe. However, other imaging technologies and methods are being investigated that will help quantify bone healing after distraction osteogenesis, providing an objective method for deciding when it is appropriate to remove an external fixator. This review will examine the latest techniques used to assess bone healing after distraction osteogenesis including dualenergy X-ray absorptiometry scans, ultrasound, quantitative computed tomography, and digital radiography (X-ray). Recommendations for clinical practice will be outlined.

Evaluation of an Endoscopic Procedure for the Treatment of Docking Site Nonunion

“…Bony union at the level of docking site was determined by anteroposterior and lateral radiographs showing 3 of 4 cortices with bridging callus. 13,14 The docking site consolidation time was the time from EDS or an open surgical technique to radiographic union. Alignment was assessed by measuring the MAD on the anteroposterior standing radiograph.…”

Comparison between upper and lower limb lengthening in patients with achondroplasia

“…The PVR has recently been validated as an objective evaluation of mineralisation in the lengthening zone. [19][20][21] It is a cheap, cost-effective and sensitive parameter for measuring callus stiffness. However, to our knowledge, no previous study has used serial PVR measurement and callus pattern analysis in cases of humeral lengthening.…”

Microwave reflectivity analysis of bone mineral density using ultra wide band antenna

“…The inability of radiographs to determine the density or other mechanical properties which help to govern the healing of bone and its structural integrity was overcome by dual‐energy X‐ray absorptiometry (DEXA) scans. DEXA helped to determine the bone mineral density (BMD) and bone mineral content which can be used to diagnose osteopenia and osteoporosis . Quantitative Computed Tomography (QCT) is based on differential absorption of ionizing radiation by calcified tissue or bone .…”

“…DEXA helped to determine the bone mineral density (BMD) and bone mineral content which can be used to diagnose osteopenia and osteoporosis . Quantitative Computed Tomography (QCT) is based on differential absorption of ionizing radiation by calcified tissue or bone . QCT is a very good indicator of bone healing and eliminates the problem of overlapping structures.…”

“…This is not suited for patients who are immobile during scanning for a prolonged duration. Moreover QCT have high cost, limited availability and higher dosage of radiation exposure compared to X‐ray and DEXA . Microwave (MW) technique is a possible and attractive alternative modality to standard X‐ray and CT methods for bone assessment applications.…”