Skip Navigation LinksHome > September/October 2002 - Volume 22 - Issue 5 > Radiographic Assessment of Bone Formation in Tibia During Di...
Journal of Pediatric Orthopaedics:
Lower Limb

Radiographic Assessment of Bone Formation in Tibia During Distraction Osteogenesis

Donnan, Leo T. F.R.A.C.S. (Orth)*; Saleh, Michael F.R.C.S.†; Rigby, Alan S. B.Sc.‡; McAndrew, Andrew M.D.†

Collapse Box


The radiologic appearance of bone formation during limb lengthening is used to judge the competence of the underlying biologic process and predict the likely time to healing. Interpretation is, however, based upon subjective parameters that have never been clearly defined. Thirty anteroposterior radiographs from pediatric tibial lengthenings were classified by four pairs of surgeons using a three-part system. Across the group, interobserver consistency showed considerable variation for all parameters tested. Pairwise analysis indicated that the surgeons directly involved in limb lengthening procedures agreed better than those whose practice was of a different nature. A second series of radiographs contained 12 radiographs with a satisfactory and 12 with a poor bone healing index (BHI). These radiographs were digitized, and an interobserver study showed significantly improved observer concordance if the images were enhanced. No feature was associated with a 100% chance of a satisfactory outcome, but certain appearances in the regenerate were associated with a better BHI than others.

© 2002 Lippincott Williams & Wilkins, Inc.

The Pediatric Orthopaedic Society of North America (POSNA)
is a group of healthcare professionals, primarily pediatric orthopaedic surgeons, dedicated to advancing musculoskeletal care of children and adolescents. JPO is our official member journal. 
Like us on facebook and become a member today!


Article Tools


Article Level Metrics

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.