Fc. Denboer et al., QUANTIFICATION OF FRACTURE-HEALING WITH 3-DIMENSIONAL COMPUTED-TOMOGRAPHY, Archives of orthopaedic and trauma surgery, 117(6-7), 1998, pp. 345-350
Quantitative methods are necessary for an objective evaluation of frac
ture healing. Three-dimensional computed tomography (CT) for the measu
rement of callus volume and density could be such a method and was inv
estigated 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 a
nd 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 s
trength and torsional stiffness increased over time (P < 0.0001, analy
sis of variance, ANOVA). Multiple regression analysis showed that the
callus volume was not related to the torsional properties. However, ca
llus density was a significant explanatory variable for both torsional
strength (R-2 = 0.72, P < 0.0001) and torsional stiffness (R-2 = 0.82
, P < 0.0001). Therefore, callus density as measured by three-dimensio
nal CT is a predictor of the extent of fracture consolidation. CT with
three-dimensional reconstruction of the callus seems a valid techniqu
e for the quantification of fracture healing.