Braunstein E M, Goldstein S A, Ku J, Smith P, Matthews L S
Skeletal Radiol. 1986;15(1):27-31. doi: 10.1007/BF00355070.
We evaluated the relative contribution of plain radiographs and computed tomography to the assessment of fracture healing under experimental circumstances. In 15 sheep, we performed midshaft femoral osteotomies and internal fixation of the resultant segmental fractures. Radiographs were obtained preoperatively and immediately postoperatively. Animals were sacrificed at 3 weeks, 6 weeks, 12 weeks, 24 weeks, and 36 weeks after surgery, and the femoral specimens radiographed. After removal of the internal fixation devices, computed tomographic scans of the specimens were performed. By 3 weeks, callus was visible, but at 6 weeks, a trabecular pattern in the callus was seen on plain films but not on computed tomography. There was progressive organization of the callus on both studies. At 24 weeks, computed tomography demonstrated fracture lines not seen due to overlying callus on plain films and also more accurately showed incomplete union. By 36 weeks, healing was essentially complete according to both modalities, although there still were small gaps in the callus detectable on computed tomography but not on plain films. Computed tomography may be of value in the evaluation of fractures of long bones in those cases in which clinical examination and plain radiographs fail to give adequate information as to the status of healing.
我们评估了在实验条件下，X线平片和计算机断层扫描在评估骨折愈合方面的相对贡献。对15只绵羊进行股骨干中段截骨术，并对由此产生的节段性骨折进行内固定。术前和术后即刻拍摄X线片。在术后3周、6周、12周、24周和36周处死动物，并对股骨标本进行X线摄影。取出内固定装置后，对标本进行计算机断层扫描。到3周时可见骨痂，但在6周时，平片上可见骨痂中的小梁结构，而计算机断层扫描上未见。两项研究中骨痂均有逐渐的组织化。在24周时，计算机断层扫描显示平片上因骨痂覆盖而未见的骨折线，并且更准确地显示了骨折未完全愈合。到36周时，根据两种检查方式，愈合基本完成，尽管计算机断层扫描仍可检测到骨痂中有小间隙，而平片上未显示。在临床检查和X线平片未能提供关于愈合状态的充分信息的情况下，计算机断层扫描在评估长骨骨折方面可能具有价值。
