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Quantitative and qualitative assessment of closed fracture healing using computed tomography and conventional radiography

, : Quantitative and qualitative assessment of closed fracture healing using computed tomography and conventional radiography. Academic Radiology 10(11): 1267-1273

Development of new agents to induce fracture healing requires more sensitive methods to detect early changes in fracture repair. The aims of this study were to determine quantitative and qualitative features of fracture healing using volumetric computed tomography (CT) and to compare them with conventional radiography during the weeks following uncomplicated fractures of the appendicular skeleton. 39 otherwise healthy men and women with acute, closed fractures of the distal radius, tibial and/or fibular malleoli, or tibial shaft, were enrolled and underwent CT and X-ray imaging at 1, 2, 4, 8, 12, and 16 (tibial shaft only) weeks post fracture. Qualitative assessment included fracture line/margins, fracture gap, external callus appearance, callus-to-cortex ratio, bridging, and radiologic union. Quantitative assessment of CT density changes (Hounsfield units [HU]) in the fracture gap was performed in a subset of 8 fracture patients using MEDx multimodality image analysis software (Sterling,VA). The analysis was performed by drawing free form regions of interest (ROI) covering the fracture gap on baseline (week 1) images and by automated registration of the follow-up images to the baseline co-ordinate system. The mean time to achieve radiologic union on CT was slightly shorter than on X-rays for radial and tibial shaft fractures (7.3 vs. 8.0 weeks, P = .1). Blurring of the fracture margins and reactive sclerosis were the earliest signs of healing in both modalities. External callus formation was evident in 11 cases and was detected earlier with CT technique. Overall, CT images allowed for more complete and detailed visualization of healing compared with conventional X-rays, which were limited by cast and fixation hardware superimposition, especially in subjects with malleolar and distal radial fractures. Quantitative evaluation showed good intraobserver and interobserver reproducibility and a statistically significant correlation to qualitative changes. Our methods of fracture healing assessment are reliable tools that are able to detect early changes in normal bone healing and may serve as useful additions to subjective image analysis in monitoring fracture healing in clinical trials. CT shows some advantages over conventional X-rays in evaluation of early fracture healing.


PMID: 14626301

Other references

Lipskaya, NYa., 1980: The feeding and food requirements of the young smallwing flyingfish Oxyporhamphus micropterus micropterus Val. (Hemirhamphidae). Food spectrum and daily feeding rhythm were determined in young O. m. micropterus (Val.) from the epipelagic zone of the Pacific and Indian Oceans. Food included Siphonophora, Copepoda, Pontellidae nauplii, Copepoda nauplii, Gastropoda larvae, Pte...

Charrier, L.; Moiraghi Ruggenini, A.; Renga, G.; Ditommaso, S.; Lievre, M.A.; Zotti, C., 2004: Cost analysis of toxoplasma infection control in pregnancy. In Italy, the management of Toxoplasma infection screening in pregnant women is often unproductive and inefficient and generates a wide variability of costs. This study evaluated performance parameters in the screening management of a population o...

Bakhoum, S.F.W.; Agnes, G.R., 2005: Study of chemistry in droplets with net charge before and after Coulomb explosion: ion-induced nucleation in solution and implications for ion production in an electrospray. Droplets with net charge are essential intermediaries in the production of gaseous ions in the electrospray (ES) ion source. There could be a wealth of knowledge regarding the chemistry that occurs in such droplets as a result of their violation o...

Hopton Nathan R.; Mazhar Farrukh M., 1985: Geotechnical aspects of Strontia Springs arch Dam. Pages 33-46 1985

Richardson, V.C.G., 2000: Diseases of domestic guinea pigs. In the new edition, information on treatments is updated, and there is a new chapter on homeopathic and herbal remedies suitable for guineapigs.

Mavor, G.E.; Bennett, B.; Galloway, J.M.; Karmody, A.M., 1969: Streptokinase in iliofemoral venous thrombosis. British Journal of Surgery 56(8): 564-567

Murnaghan, D.; Morrison, W.; Griffith, E.J.; Bell, B.L.; Duffley, L.A.; McGarry, K.; Manske, S., 2014: Knowledge exchange systems for youth health and chronic disease prevention: a tri-provincial case study. The research teams undertook a case study design using a common analytical framework to investigate three provincial (Prince Edward Island, New Brunswick and Manitoba) knowledge exchange systems. These three knowledge exchange systems seek to gene...

Shimoda, K., 2006: Diagnosis and treatment of polycythemia. Nihon Naika Gakkai Zasshi. Journal of the Japanese Society of Internal Medicine 95(10): 2060-2066

Ritter, A.; Bellanger, B., 1996: Stakes in education. Continuing education: why?. Soins; la Revue de Reference Infirmiere: 90-94

Schriner, S.E.; Smith, A.C.; Dang, N.H.; Fukuchi, K.I.hiro; Martin, G.M., 2000: Overexpression of wild-type and nuclear-targeted catalase modulates resistance to oxidative stress but does not alter spontaneous mutant frequencies at APRT. Animal cells generate hydrogen peroxide as a byproduct of energy metabolism. In the presence of reduced metals H2O2, can decompose to a highly reactive hydroxyl radical that attacks essentially all organic molecules, including DNA. We wished to de...