Quantitative assessment of mineralization in distraction osteogenesis

Sunit Hazra, Hae Ryong Song, Sandeep Biswal, Suk Ha Lee, Seok Hyun Lee, Ki-Mo Jang, Hitesh N. Modi

Research output: Contribution to journalArticlepeer-review

38 Citations (Scopus)


Objectives: The most important decision in distraction osteogenesis is the timing of fixator removal. Various methods have been tried, such as radiographic appearance of callus and bone mineral density (BMD) assessment, but none has acquired gold standard status. The purpose of this study was to develop another objective method of assessment of callus stiffness to help clinicians in taking the most important decision of when to remove the fixator. Materials and methods: We made a retrospective study of 70 patients to compare the BMD ratio and pixel value ratio. These ratios were calculated at the time of fixator removal, and Pearson's coefficient of correlation was used to show the comparability. Inter- and intra-observer variability of the new method was also tested. Results: Good correlation was found between BMD ratio and pixel value ratio, with a Pearson's coefficient of correlation of 0.79. The interobserver variability was also low, with high intra-observer reproducibility, suggesting that this test was simple to perform. Conclusion: Pixel value ratio is a good method for assessing callus stiffness, and it can be used to judge the timing of fixator removal.

Original languageEnglish
Pages (from-to)843-847
Number of pages5
JournalSkeletal Radiology
Issue number9
Publication statusPublished - 2008 Sept


  • BMD
  • Callus stiffness
  • Distraction osteogenesis
  • Ilizarov
  • Lengthening
  • Pixel

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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