Fracture stiffness in callotasis determined by dual-energy X-ray absorptiometry scanning

Assessing healing after distraction limb lengthening is essential to manage patients undergoing callotasis for leg lengthening or bone transport. Direct measurement of fracture stiffness can assess healing but the equipment may not be available. In addition, it requires removal of the fixator, which...

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Published inJournal of pediatric orthopaedics. B Vol. 10; no. 3; p. 248
Main Authors Tselentakis, G, Owen, P J, Richardson, J B, Kuiper, J H, Haddaway, M J, Dwyer, J S, Evans, G A
Format Journal Article
LanguageEnglish
Published United States 01.07.2001
Subjects
Absorptiometry, Photon - instrumentation
Absorptiometry, Photon - methods
Adolescent
Adult
Biomechanical Phenomena
Bone Density
Bone Lengthening - adverse effects
Bone Lengthening - methods
Bone Regeneration
Compliance
Female
Femur - abnormalities
Femur - diagnostic imaging
Femur - surgery
Fracture Healing
Humans
Linear Models
Male
Microcomputers
Middle Aged
Radionuclide Imaging
Tibia - abnormalities
Tibia - diagnostic imaging
Tibia - surgery
Time Factors
Treatment Outcome
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Summary:Assessing healing after distraction limb lengthening is essential to manage patients undergoing callotasis for leg lengthening or bone transport. Direct measurement of fracture stiffness can assess healing but the equipment may not be available. In addition, it requires removal of the fixator, which may be complicated for ring fixators. The present study investigates whether an equivalent measure of healing can be based on the mineral density pattern from dual-energy X-ray absorptiometry (DXA) scans. Nine consecutive patients undergoing callotasis were studied. Bending stiffness of the distraction segment was measured and DXA scans were performed regularly starting 6 weeks after completing distraction. In all, 23 simultaneous readings of bending stiffness and DXA scans were obtained. All density patterns showed a distinct minimum value of bone mineral density. We found a high and significant correlation between fracture bending stiffness and the square of the total mineral content at the location of minimum bone density (r2 = 0.77, P < 0.001). We conclude that DXA scans can be used reliably and effectively to determine fracture bending stiffness, valuable for determining both time of frame removal and delay in union.
ISSN:1060-152X
DOI:10.1097/00009957-200107000-00016