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Archives of Orthopaedic and Trauma Surgery
Published in: Archives of Orthopaedic and Trauma Surgery 10/2011

01-10-2011 | Orthopaedic Surgery

Comparative study of callus progression in limb lengthening with or without intramedullary nail with reference to the pixel value ratio and the Ru Li’s classification

Authors: Xiao-Tang Sun, T. R. Easwar, Manesh Stephen, Sang-Heon Song, Seung-Ju Kim, Hae-Ryong Song

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 10/2011

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Abstract

Introduction

Callus progression is a great concern during limb lengthening. In this study, we investigated the difference in callus progression between tibial lengthenings with and without intramedullary nail.

Method

Seventy tibiae in 38 patients with an average age of 24 years were lengthened with Ilizarov external fixator and nail; 56 tibiae in 40 patients with an average age of 28.6 years were lengthened with the same Ilizarov external fixator but without nail. The callus progression was compared with reference to pixel value ratio (PVR) and Ru Li’s classification. Statistical analysis was performed to compare the variation trend of PVR and incidence of various callus pathways (particular patterns of callus progression as outlined in Ru Li’s classification) and shapes of each aspect of callus between the two groups.

Results

The trend of PVR was not statistically different in posterior, lateral and medial aspects of the callus between the two groups, but averagely lower in the anterior aspect in the group without nail than that with nail. The group without nail presented less incidence of homogeneous pathway, greater incidence of heterogeneous pathway; also greater incidence of fusiform callus, less incidence of cylindrical callus.

Conclusion

It was concluded that with nail, the callus underwent a more favorable progression and even longer lengthening could be allowed.
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Metadata
Title
Comparative study of callus progression in limb lengthening with or without intramedullary nail with reference to the pixel value ratio and the Ru Li’s classification
Authors
Xiao-Tang Sun
T. R. Easwar
Manesh Stephen
Sang-Heon Song
Seung-Ju Kim
Hae-Ryong Song
Publication date
01-10-2011
Publisher
Springer-Verlag
Published in
Archives of Orthopaedic and Trauma Surgery / Issue 10/2011
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-011-1302-9

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