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Title: Use of periosteal markers and DXA to monitor healing in callotasis
Author: Tselentakis, George.
ISNI:       0000 0001 3537 1520
Awarding Body: Keele University
Current Institution: Keele University
Date of Award: 2005
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Callotasis has been studied extensively. The major applications of the technique in trauma and congenital disorders demand objective measures to monitor its progress. Periosteum is thought to be important by all authors, providing a guiding envelope during new bone formation and an important source of osteogenic cells. We labelled the periosteum with markers in 7 patients undergoing callotasis. This enables us to monitor its continuity and mode of elongation in an efficient way. The periosteum elongates throughout the distraction phase. We found that the strains during distraction indicate differential growth at different parts of it. We also found that periosteum was not transfixed by the pins or wires of the external fixator but the fixation points into bone were at different sites. The single most important factor that correlated with healing of the regenerate was continuity of the periosteum, which was efficiently monitored by the movement of the markers. During the consolidation phase 23 simultaneous measurements of bending stiffness of the regenerate and DXA scans were obtained on 9 patients that underwent callotasis. Of these measurements, 15 were of tibias and 9 of femurs. Linear correlation was calculated between the bending fracture stiffness and several parameters derived from DXA scans that reflect mineralisation patterns of the regenerate. The highest correlation (,-2=0.77, p<0.001) was found with the linear density. Therefore, we were able to link what many people have long regarded as a promising technique (non-invasive densitometry) and what is currently regarded as the most reliable outcome measure (stiffness). That, we would think, is an important step as an end-point is derived that might allow safe removal of the fixator.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available