den Boer F C, Bramer J A, Patka P, Bakker F C, Barentsen R H, Feilzer A J, de Lange E S, Haarman H J
Department of Surgery, Free University Hospital, Amsterdam, The Netherlands.
Arch Orthop Trauma Surg. 1998;117(6-7):345-50. doi: 10.1007/s004020050263.
Quantitative methods are necessary for an objective evaluation of fracture healing. Three-dimensional computed tomography (CT) for the measurement of callus volume and density could be such a method and was investigated 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 and 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 strength and torsional stiffness increased over time (P < 0.0001, analysis of variance, ANOVA). Multiple regression analysis showed that the callus volume was not related to the torsional properties. However, callus density was a significant explanatory variable for both torsional strength (R2 = 0.72, P < 0.0001) and torsional stiffness (R2 = 0.82, P < 0.0001). Therefore, callus density as measured by three-dimensional CT is a predictor of the extent of fracture consolidation. CT with three-dimensional reconstruction of the callus seems a valid technique for the quantification of fracture healing.
定量方法对于客观评估骨折愈合是必要的。用于测量骨痂体积和密度的三维计算机断层扫描（CT）可能就是这样一种方法，并在动物模型中进行了研究。在23只山羊身上制造了闭合性胫骨骨折并用石膏固定。在2周、4周和6周时处死动物进行影像学、CT和生物力学分析。从CT扫描中对骨痂进行三维重建以测量其体积和平均密度。在2周时骨痂体积已达到最大值。相比之下，骨痂密度、抗扭强度和抗扭刚度随时间增加（方差分析，P < 0.0001）。多元回归分析表明骨痂体积与抗扭性能无关。然而，骨痂密度是抗扭强度（R2 = 0.72，P < 0.0001）和抗扭刚度（R2 = 0.82，P < 0.0001）的重要解释变量。因此，通过三维CT测量的骨痂密度是骨折愈合程度的一个预测指标。对骨痂进行三维重建的CT似乎是一种用于量化骨折愈合的有效技术。
