IMAGING IN BONE LENGTHENING

Limb lengthening using callotasis needs careful preoperative planning and great care during the lengthening period. The most common method u sed to monitor limb lengthening is plain radiography, but the time of frame removal is still left to the judgment of the surgeon. This paper reviews some of the methods used experimentally and clinically to mon itor the process, outlining their possible advantages and disadvantage s for application in routine clinical practice. Considering availabili ty, cost, and safety, an imaging protocol could involve preoperative a ssessment with computed tomography scan; immediate postoperative anter oposterior (AP) and lateral radiographs; weekly ultrasound scanning fo r the 1st 8 weeks; and monthly AP and lateral radiographs during the l engthening phase and if there is any clinical suspicion of complicatio n during the consolidation phase. If available, dual energy bone densi tometry can be performed every 2 to 4 weeks from 8 weeks, until remova l of the fixator.