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The early posterior cortex pixel value ratio: a novel reliable indicator for distraction osteogenesis
Ze Liu1,2, Qi Liu1,3, Min Wang2,4
1Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China.
Frontiers in Surgery
|November 15, 2023
Summary
The posterior cortex PVR grows faster in bone union cases, showing an asymmetrical pattern. This posterior PVR is linked to bone healing indices, suggesting its potential as a diagnostic tool.
Area of Science:
- Orthopedics
- Biomedical Engineering
- Regenerative Medicine
Background:
- Bone healing is crucial for fracture recovery.
- Assessing bone regeneration accurately aids treatment decisions.
- Understanding asymmetrical growth patterns can improve outcomes.
Purpose of the Study:
- To investigate the associations of early periosteal volume ratio (PVR) in four cortices with bone healing indices.
- To compare PVR in bone union and non-union groups.
- To explore PVR as a potential indicator in distraction osteogenesis (DO).
Main Methods:
- Recruited 52 patients (39 bone union, 13 non-union).
- Analyzed early PVR in medial, lateral, anterior, and posterior cortices.
- Correlated PVR with Healing Index (HI), Lengthening Index (LI), and External Fixator Index (EFI).
Main Results:
- Bone union group showed asymmetrical callus growth, with faster posterior PVR.
- Posterior PVR was significantly higher in the bone union group compared to the non-union group.
- Posterior PVR was inversely associated with HI, LI, and EFI in the bone union group.
Conclusions:
- Early posterior cortex PVR demonstrates asymmetrical growth in bone union.
- Posterior PVR negatively correlates with HI, LI, and EFI, indicating its significance in bone healing.
- Posterior cortex PVR may serve as a novel index for monitoring distraction osteogenesis.

