Tibial shaft fractures: assessment of fracture healing with computed tomography.
OBJECTIVE
To assess the capability of CT in assessing stability of tibial shaft fractures with planimetry.


METHODS
Eighteen patients with fracture of the tibial shaft were treated by external fixator. All patients underwent CT 1, 6, 12, and 18 weeks postoperatively to assess the fracture healing. The callus formation and compacta were determined with planimetry. Fractometry, a noninvasive method to measure stability, was used as the gold standard to determine the stability of the fracture.


RESULTS
The patients were divided into three groups according to different periods of time for removal of external fixation. Twelve patients with stable fractures showed a steady increase of callus, which was 50% higher after 12 weeks. Three patients with delayed fracture healing demonstrated an increase of callus of > 50% after 18 weeks. Three patients with unstable fractures obtained only callus formation of < 20% after 15-18 weeks. The external fixator was removed and endomedullary nails were used for stabilization.


CONCLUSIONS
The CT data allow quantification of callus and compacta formation and are able to determine the stability of tibial shaft fractures.
Schnarkowski
P
P
Department of Radiology, University of California, San Francisco, USA.
Rédei
J
J
Peterfy
C G
CG
Weidenmaier
W
W
Mutschler
W
W
Arand
M
M
Reiser
M F
MF
D000293:Adolescent; D000328:Adult; D001858:Bone Nails; D002146:Bony Callus / Q000000981:diagnostic imaging / Q000473:pathology; D002648:Child; D016267:External Fixators; D005260:Female; D005500:Follow-Up Studies; D005592:Fracture Fixation / Q000295:instrumentation; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation; D017102:Fracture Healing; D005596:Fractures, Closed / Q000000981:diagnostic imaging / Q000601:surgery; D005597:Fractures, Open / Q000000981:diagnostic imaging / Q000601:surgery; D005599:Fractures, Ununited / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D013314:Stress, Mechanical; D013978:Tibial Fractures / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D013997:Time Factors; D014057:Tomography, X-Ray Computed