The traditional assessment of fracture healing by manipulation and vie
wing of radiographs is subjective and qualitative. Dual energy xray ab
sorptiometry by contrast provides an accurate, precise, and minimally
invasive quantitative measure of bone mineral density, a property that
shows strong correlations with various mechanical properties of bone.
Fourteen patients with unilateral tibial shaft fractures stabilized b
y external fixation were monitored with dual energy xray absorptiometr
y at monthly intervals after fracture. Fractured and contralateral unf
ractured bones (controls) were scanned on each occasion. Changes in mi
neralization with time over the whole length of the fractured bone cou
ld be seen. The most pronounced effects were visible in the area of th
e fracture, with a minimum recorded fracture site bone mineral density
of 38 +/- 13% of contralateral values, but often more long term alter
ations in bone mineral density affected regions at some distance from
this zone. Significantly, in four patients who had scans 5 or more mon
ths after fracture, the mineralization at the fracture site had return
ed to control levels, whereas bone mineral density in a region proxima
l to the fracture showed evidence of persisting posttraumatic osteopor
osis.