Department of Trauma and Microreconstructive Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, P.R. China.
Xinjiang Key Laboratory of Trauma Repair and Reconstruction, Urumqi, Xinjiang, P.R. China.
J Orthop Surg Res. 2024 Nov 6;19(1):727. doi: 10.1186/s13018-024-05200-1.
The management of docking site healing in bone transport remains a significant challenge in orthopedic surgery. Traditional assessment methods rely heavily on qualitative radiographic evaluations. This study investigates the utility of pixel value ratio (PVR), an objective quantitative measure, in assessing bone healing at the docking site during bone transport.
This retrospective study included 47 patients who underwent bone transport for lower limb reconstruction between January 2015 and January 2020. Patients were categorized into bone union (n = 35) and nonunion (n = 12) groups based on docking site outcomes. PVR was calculated using two methods (PVR1 and PVR2) at six time points over 24 months post-docking. Subgroup analyses were performed based on gender, age, and surgical site.
Of 47 patients, 35 achieved bone union and 12 experienced nonunion. Both PVR1 and PVR2 were consistently lower in the union group compared to the nonunion group at all time points (p < 0.001). In the union group, PVR1 ranged from 1.064 ± 0.050 to 1.108 ± 0.062, while PVR2 ranged from 0.926 ± 0.079 to 0.946 ± 0.062. In the nonunion group, PVR1 ranged from 1.204 ± 0.057 to 1.273 ± 0.020, and PVR2 from 1.039 ± 0.060 to 1.148 ± 0.022. Subgroup analyses revealed that males had significantly lower PVR values compared to females, and tibial cases had lower PVR values compared to femoral cases in both union and nonunion groups (p < 0.05). All juvenile patients achieved union, compared to 71.4% of adults (p < 0.01).
PVR demonstrates significant potential as an objective tool for assessing docking site healing in bone transport procedures. The distinct patterns observed between union and nonunion cases provide a foundation for developing clinical guidelines to monitor and predict healing outcomes. Integration of PVR assessment into clinical practice could improve decision-making and optimize treatment protocols in bone transport procedures.
在骨搬运过程中，对接部位愈合的管理仍然是骨科手术中的一个重大挑战。传统的评估方法主要依赖于定性的放射学评估。本研究旨在探讨像素值比（PVR）这一客观定量测量指标在评估骨搬运过程中对接部位骨愈合的应用价值。
本回顾性研究纳入了 2015 年 1 月至 2020 年 1 月期间接受下肢重建骨搬运的 47 例患者。根据对接部位的结果，将患者分为骨愈合组（n=35）和非愈合组（n=12）。在 24 个月的对接后时间点，使用两种方法（PVR1 和 PVR2）计算 PVR。并根据性别、年龄和手术部位进行亚组分析。
47 例患者中，35 例患者达到骨愈合，12 例患者出现非愈合。在所有时间点，愈合组的 PVR1 和 PVR2 值均明显低于非愈合组（p<0.001）。在愈合组中，PVR1 范围为 1.064±0.050 至 1.108±0.062，而 PVR2 范围为 0.926±0.079 至 0.946±0.062。在非愈合组中，PVR1 范围为 1.204±0.057 至 1.273±0.020，PVR2 范围为 1.039±0.060 至 1.148±0.022。亚组分析显示，男性的 PVR 值明显低于女性，在愈合组和非愈合组中，胫骨病例的 PVR 值均低于股骨病例（p<0.05）。所有青少年患者均达到愈合，而成年人的愈合率为 71.4%（p<0.01）。
PVR 作为一种评估骨搬运过程中对接部位愈合的客观工具具有显著的潜力。愈合组和非愈合组之间观察到的明显差异为制定监测和预测愈合结果的临床指南提供了依据。将 PVR 评估纳入临床实践可以改善决策，并优化骨搬运过程中的治疗方案。
