Quantification of fracture healing with three-dimensional computed tomography

• Published in: Archives of orthopaedic and trauma surgery Vol. 117; no. 6-7; pp. 345 - 350
• Main Authors: DEN BOER, F. C, BRAMER, J. A. M, PATKA, P, BAKKER, F. C, BARENTSEN, R. H, FEILZER, A. J, DE LANGE, E. S. M, HAARMAN, H. J. T. M
• Format: Journal Article
• Language: English
• Published: Berlin Springer 01-07-1998; Springer Nature B.V
• Subjects: Analysis of Variance; Animals; Biological and medical sciences; Biomechanical Phenomena; Bone Density; Bony Callus - diagnostic imaging; Bony Callus - physiopathology; Casts, Surgical; Disease Models, Animal; Female; Fracture Healing - physiology; Goats; Investigative techniques, diagnostic techniques (general aspects); Medical sciences; Osteoarticular system. Muscles; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Radiographic Image Enhancement - methods; Regression Analysis; Sensitivity and Specificity; Tibial Fractures - diagnostic imaging; Tibial Fractures - therapy; Tomography, X-Ray Computed - methods; Variance analysis; Evaluation; Animal model; 3D imaging; Radiodiagnosis; Diseases of the osteoarticular system; Fracture; Trauma; Vertebrata; Mammalia; Surveillance; Animal; Medical imagery; Goat; Computerized axial tomography; Artiodactyla; Bone; Technique; Cicatrization; Ungulata
• ISSN: 0936-8051; 1434-3916
• DOI: 10.1007/s004020050263

Quantitative methods are necessary for an objective evaluation of fracture healing. Three-dimensional computed tomography (CT) for the measurement of callus volume and density could be such a method and was investigated in an animal model. In 23 goats a closed tibial fracture was created and stabilized with a cast. The animals were killed at 2, 4 and 6 weeks for radiographical, CT and biomechanical analysis. From the CT scans a three-dimensional reconstruction of the callus was made to measure its volume and mean density. At 2 weeks the callus volume had already reached its maximum. In contrast, callus density, torsional strength and torsional stiffness increased over time (P < 0.0001, analysis of variance, ANOVA). Multiple regression analysis showed that the callus volume was not related to the torsional properties. However, callus density was a significant explanatory variable for both torsional strength (R2 = 0.72, P < 0.0001) and torsional stiffness (R2 = 0.82, P < 0.0001). Therefore, callus density as measured by three-dimensional CT is a predictor of the extent of fracture consolidation. CT with three-dimensional reconstruction of the callus seems a valid technique for the quantification of fracture healing.