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A modified pixel value ratio based on contralateral normal bone: a novel reliable indicator for distraction

Qi Liu1,2, Jieyu Liang1,2, Ze Liu1,2

  • 1Department of Orthopaedics, Xiangya Hospital, Central South University Changsha, Hunan, China.

American Journal of Translational Research
|March 14, 2023
PubMed
Summary

A new modified pixel value ratio (mPVR) is a reliable indicator for distraction osteogenesis (DO), outperforming the traditional method by accounting for bone changes. This aids in clinical management.

Keywords:
Bone lengtheningIlizarov techniquedistraction osteogenesisexternal fixatormodified pixel value ratioplain radiography

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Area of Science:

  • Orthopedics
  • Biomedical Engineering
  • Radiology

Background:

  • Traditional pixel value ratio (tPVR) is affected by disuse osteopenia in distraction osteogenesis (DO).
  • A modified PVR (mPVR) using contralateral normal bone was developed to overcome tPVR limitations.

Purpose of the Study:

  • To validate the modified PVR (mPVR) in distraction osteogenesis (DO).
  • To compare mPVR with traditional PVR (tPVR) in early callus formation.
  • To investigate the correlation of mPVR with healing and lengthening indices and identify influencing factors.

Main Methods:

  • Retrospective study of 79 bone lengthening subjects.
  • Comparison of mPVR and tPVR in early callus (first three months post-osteotomy).
  • Analysis of mPVR correlation with healing index (HI), lengthening index (LI), external fixator index (EFI), and influencing factors.

Main Results:

  • mPVR was significantly lower than tPVR in the first three months, with increasing differences.
  • Early mPVR (first two months) showed a negative correlation with HI, LI, and EFI.
  • Age, lengthening site, total bilirubin, and mean hemoglobin were associated with early callus mPVR during DO.

Conclusions:

  • mPVR is a novel, reliable indicator for DO, potentially aiding clinical management.
  • Further confirmation through larger prospective studies is recommended.