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Imaging Modalities to Assess Fracture Healing

  • Orthopedic Management of Fractures (M Kacena and L Gerstenfeld, Section Editors)
  • Published:
Current Osteoporosis Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

This review discusses imaging modalities for fracture repair assessment, with an emphasis on pragmatic clinical and translational use, best practices for implementation, and challenges and opportunities for continuing research.

Recent Findings

Semiquantitative radiographic union scoring remains the clinical gold standard, but has questionable reliability as a surrogate indicator of structural bone healing, particularly in early-stage, complex, or compromised healing scenarios. Alternatively, computed tomography (CT) scanning enables quantitative assessment of callus morphometry and mechanics through the use of patient-specific finite-element models. Dual-energy X-ray absorptiometry (DXA) scanning and radiostereometric analysis (RSA) are also quantitative, but technically challenging. Nonionizing magnetic resonance (MR) and ultrasound imaging are of high interest, but require development to enable quantification of 3D mineralized structures.

Summary

Emerging image-based methods for quantitative assessment of bone healing may transform clinical research design by displacing binary outcomes classification (union/nonunion) and ultimately enhance clinical care by enabling early nonunion detection.

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Authors and Affiliations

  1. Department of Mechanical Engineering & Mechanics, Lehigh University, Bethlehem, PA, USA

    Peter Schwarzenberg & Hannah L. Dailey

  2. Musculoskeletal Research Unit (MSRU), Vetsuisse Faculty, University of Zürich, Zürich, Switzerland

    Salim Darwiche

  3. Center for Applied Biotechnology and Molecular Medicine (CABMM), University of Zürich, Zürich, Switzerland

    Salim Darwiche

  4. Division of Orthopaedic Trauma, Department of Orthopaedic Surgery, Jersey City Medical Center – RWJBarnabas Health, Jersey City, NJ, USA

    Richard S. Yoon

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  1. Peter Schwarzenberg
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Correspondence to Hannah L. Dailey.

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This article is part of the Topical Collection on Orthopedic Management of Fractures

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Schwarzenberg, P., Darwiche, S., Yoon, R.S. et al. Imaging Modalities to Assess Fracture Healing. Curr Osteoporos Rep 18, 169–179 (2020). https://doi.org/10.1007/s11914-020-00584-5

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