Quantitative Assessment of Mineralization in Distraction Osteogenesis

Overview

Journal Skeletal Radiol

Specialties Orthopedics
Radiology

Date 2008 Apr 26

PMID 18437377

Citations 23

Authors

Sunit Hazra

Hae-Ryong Song

Sandeep Biswal

Suk-Ha Lee

Seok Hyun Lee

Ki-Mo Jang

Hitesh N Modi

Affiliations

Soon will be listed here.

Abstract

Objectives: The most important decision in distraction osteogenesis is the timing of fixator removal. Various methods have been tried, such as radiographic appearance of callus and bone mineral density (BMD) assessment, but none has acquired gold standard status. The purpose of this study was to develop another objective method of assessment of callus stiffness to help clinicians in taking the most important decision of when to remove the fixator.

Materials And Methods: We made a retrospective study of 70 patients to compare the BMD ratio and pixel value ratio. These ratios were calculated at the time of fixator removal, and Pearson's coefficient of correlation was used to show the comparability. Inter- and intra-observer variability of the new method was also tested.

Results: Good correlation was found between BMD ratio and pixel value ratio, with a Pearson's coefficient of correlation of 0.79. The interobserver variability was also low, with high intra-observer reproducibility, suggesting that this test was simple to perform.

Conclusion: Pixel value ratio is a good method for assessing callus stiffness, and it can be used to judge the timing of fixator removal.

Citing Articles

The mechanical test as a supplemental decision support tool for the safe removal of an Ilizarov circular external fixator.

Xu Y, Liu J, Yang J, Zhang T, Li Z, Liu Y Eur J Med Res. 2025; 30(1):83.

PMID: 39920873 PMC: 11804065. DOI: 10.1186/s40001-024-02258-9.

Optimizing bone transport strategies: a pixel value ratio-based evaluation of regeneration rates in bifocal and trifocal techniques.

Yang X, Hamiti Y, Liu K, Wang S, Kadier X, Xiong D Front Surg. 2024; 11:1494658.

PMID: 39720628 PMC: 11666508. DOI: 10.3389/fsurg.2024.1494658.

Objective assessment of docking site consolidation in bone transport: the role of pixel value ratio in predicting healing outcomes.

Yang X, Hamiti Y, Liu K, Wang S, Kadier X, Xiong D J Orthop Surg Res. 2024; 19(1):727.

PMID: 39506770 PMC: 11542437. DOI: 10.1186/s13018-024-05200-1.

Application of the Modified RUST Score in Tibial Bone Transport and Factors Associated with Docking Site Complications.

Kummer A, Nieuwoudt L, Marais L Strategies Trauma Limb Reconstr. 2024; 19(2):73-81.

PMID: 39359357 PMC: 11443615. DOI: 10.5005/jp-journals-10080-1621.

A Novel Method to Assess Healing of Segmental Bone Defects using the Induced Membrane Technique.

Wang P, Ma Y, Wang Y, Zhou M, Liu J, Rui Y Orthop Surg. 2024; 16(8):1991-1998.

PMID: 38946673 PMC: 11293926. DOI: 10.1111/os.14157.

References

Swaton N . Learn from experience: insights of 200+ PACS customers. Radiol Manage. 2002; 24(1):22-7. View

Minty I, Maffulli N, Hughes T, Shaw D, Fixsen J . Radiographic features of limb lengthening in children. Acta Radiol. 1994; 35(6):555-9. View

Maffulli N, Hughes T, Fixsen J . Ultrasonographic monitoring of limb lengthening. J Bone Joint Surg Br. 1992; 74(1):130-2. DOI: 10.1302/0301-620X.74B1.1732241. View

Fischgrund J, Paley D, SUTER C . Variables affecting time to bone healing during limb lengthening. Clin Orthop Relat Res. 1994; (301):31-7. View

Eyres K, Bell M, Kanis J . New bone formation during leg lengthening. Evaluated by dual energy X-ray absorptiometry. J Bone Joint Surg Br. 1993; 75(1):96-106. DOI: 10.1302/0301-620X.75B1.8421047. View

Dugas M, Trumm C, Stabler A, Pander E, Hundt W, Scheidler J . Case-oriented computer-based-training in radiology: concept, implementation and evaluation. BMC Med Educ. 2001; 1:5. PMC: 58833. DOI: 10.1186/1472-6920-1-5. View

Guichet J, Braillon P, Bodenreider O, Lascombes P . Periosteum and bone marrow in bone lengthening: a DEXA quantitative evaluation in rabbits. Acta Orthop Scand. 1998; 69(5):527-31. DOI: 10.3109/17453679808997792. View

Kabachinski J . DICOM: key concepts--part I. Biomed Instrum Technol. 2005; 39(3):214-6. DOI: 10.2345/0899-8205(2005)39[214:DKCI]2.0.CO;2. View

Eyres K, Bell M, Kanis J . Methods of assessing new bone formation during limb lengthening. Ultrasonography, dual energy X-ray absorptiometry and radiography compared. J Bone Joint Surg Br. 1993; 75(3):358-64. DOI: 10.1302/0301-620X.75B3.8496200. View

10.

Shim J, Chung K, Ahn J . Value of measuring bone density serial changes on a picture archiving and communication systems (PACS) monitor in distraction osteogenesis. Orthopedics. 2002; 25(11):1269-72. DOI: 10.3928/0147-7447-20021101-19. View

11.

Young J, Kovelman H, Resnik C, Paley D . Radiologic assessment of bones after Ilizarov procedures. Radiology. 1990; 177(1):89-93. DOI: 10.1148/radiology.177.1.2399344. View

12.

De Backer A, Mortele K, De Keulenaer B . Picture archiving and communication system--Part one: Filmless radiology and distance radiology. JBR-BTR. 2004; 87(5):234-41. View

13.

Minematsu K, Tsuchiya H, Taki J, Tomita K . Blood flow measurement during distraction osteogenesis. Clin Orthop Relat Res. 1998; (347):229-35. View

14.

Tselentakis G, Owen P, Richardson J, Kuiper J, Haddaway M, Dwyer J . Fracture stiffness in callotasis determined by dual-energy X-ray absorptiometry scanning. J Pediatr Orthop B. 2001; 10(3):248-54. View

15.

Maffulli N, Cheng J, Sher A, Ng B, Ng E . Bone mineralization at the callotasis site after completion of lengthening. Bone. 1999; 25(3):333-8. DOI: 10.1016/s8756-3282(99)00168-4. View

16.

Starr K, Fillman R, Raney E . Reliability of radiographic assessment of distraction osteogenesis site. J Pediatr Orthop. 2003; 24(1):26-9. DOI: 10.1097/00004694-200401000-00006. View

17.

Ilizarov G . Clinical application of the tension-stress effect for limb lengthening. Clin Orthop Relat Res. 1990; (250):8-26. View

18.

Salmas M, Nikiforidis G, Sakellaropoulos G, Kosti P, Lambiris E . Estimation of artifacts induced by the Ilizarov device in quantitative computed tomographic analysis of tibiae. Injury. 1999; 29(9):711-6. DOI: 10.1016/s0020-1383(98)80162-9. View

19.

Passadore D, Isoardi R, Ariza P, Padin C . Use of a low-cost, PC-based image review workstation at a radiology department. J Digit Imaging. 2001; 14(2 Suppl 1):222-3. PMC: 3452710. DOI: 10.1007/BF03190346. View