USE OF RADIOGRAPHIC CLASSIFICATION SYSTEM IN DISTRACTION OSTEOGENESIS

Abstract

Purpose: To evaluate the clinical outcome in patients with different radiographic features of the regenerate within the radiographic classification system judged by the bone healing index (BHI) Material and methods: The study has included 27 patients with limb lengthening using the Ilizarov method at the Clinic for Orthopaedic Surgery in Skopje from 2013 to 2020.27 segments have been analyzed using the classification system of Ru Li, Michael Saleh, Lang Yang, Les Coulton. The classification is based on the shape of the callus and on the type of feature of distraction osteogenesis. The results were classified in two groups: Results with BHI under 50 days/cm and over 50 days/cm. The results for BHI were correlated with the shape of the callus, and with the type of feature at the distraction site. Results: In 8 of 10 cases grouped in the first of five callus shape modalities, there was a more rapid bone healing than in the rest of the cases (80%).In 5 of 8 patients classified in the second type (67,5.%), the BHI was under 50 days/cm. In the other patients representing type 3,4 and 5, BHI was over 50 days/cm in more than 66,66%, Only one patient presented type 5, with BHI of 69,45. In patients with 2,6 and 9 type of feature, BHI was under 50 days/cm. In type 8 and 10, we had to change the rhythm of distraction.In one patient with type 1 of feature, a final modification of the frame was necessary. Conclusion: Use of this classification system in limb lengthening procedures can not only detect, but also predict the healing pattern of the bone and thereby allow therapeutic corrections to be made at the appropriate time in order to improve the final outcome of the treatment.