Abstract
Since its introduction by Ilizarov, the distraction osteogenesis technique has been
used to treat trauma-related conditions, infections, bone tumors, and congenital diseases,
either as methods of bone transport or elongation. One of the major dilemmas for the
orthopedic surgeon who performs osteogenic distraction is establishing a reproducible
method of assessing the progression of the osteogenesis, enabling the early detection
of regenerate failures, in order to effectively interfere during treatment, and to
determine the appropriate time to remove the external fixator. Several quantitative
monitoring methods to evaluate the structural recovery and biomechanical properties
of the bone regenerate at different stages, as well as the bone healing process, are
under study. These methods can reveal data on bone metabolism, stiffness, bone mineral
content, and bone mineral density. The present review comprehensively summarizes the
most recent techniques to assess bone healing during osteogenic distraction, including
conventional radiography and pixel values in digital radiology, ultrasonography, bone
densitometry and scintigraphy, quantitative computed tomography, biomechanical evaluation,
biochemical markers, and mathematical models. We believe it is crucial to know the
different methods currently available, and we understand that using several monitoring
methods simultaneously can be an ideal solution, pointing to a future direction in
the follow-up of osteogenic distraction.
Keywords
quantitative evaluation - osteogenic distraction - biomechanical phenomena - external
fixation - X-ray
