Optimizing bone transport strategies: a pixel value ratio-based evaluation of regeneration rates in bifocal and trifocal techniques.

IF 1.6 4区医学 Q2 SURGERY

Frontiers in Surgery Pub Date : 2024-12-10 eCollection Date: 2024-01-01 DOI:10.3389/fsurg.2024.1494658

Xin Yang, Yimurang Hamiti, Kai Liu, Sulong Wang, Xiriaili Kadier, Debin Xiong, Aihemaitijiang Yusufu

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引用次数: 0

Abstract

Background: Bone transport techniques are crucial for managing large bone defects, but the optimal approach for different defect lengths remains unclear. This study aimed to compare bone regeneration rates between short bifocal bone transport (SBBT), long bifocal bone transport (LBBT), and trifocal bone transport (TBT) using pixel value ratio (PVR) as an objective quantitative measure.

Methods: This retrospective study included 60 patients undergoing lower limb bone transport, divided into SBBT (n = 22, defects <6 cm), LBBT (n = 20, defects ≥6 cm), and TBT (n = 18, defects ≥6 cm) groups. PVR was measured at 4, 8, and 12 weeks postoperatively using standardized digital radiographs. Healing index (HI) and external fixation index (EFI) were calculated to assess treatment efficiency. Demographic data, surgical characteristics, and complications were also analyzed.

Results: TBT showed significantly higher PVR values compared to LBBT at all time points (4 weeks: 0.779 ± 0.036 vs. 0.719 ± 0.027, p < 0.001; 8 weeks: 0.822 ± 0.027 vs. 0.787 ± 0.025, p = 0.008; 12 weeks: 0.866 ± 0.024 vs. 0.835 ± 0.016, p = 0.023) and to SBBT at 4 and 8 weeks (p < 0.001 and p = 0.016, respectively). The TBT group demonstrated significantly lower HI and EFI compared to both SBBT and LBBT groups (p < 0.05), indicating faster healing and shorter treatment times. Although SBBT showed slightly higher PVR values than LBBT, the differences were not statistically significant.

Conclusion: Trifocal bone transport leads to faster bone regeneration and shorter treatment times compared to bifocal techniques, particularly for longer bone defects. The study demonstrates that defect length alone may not be the primary factor influencing regeneration rates in bifocal transport. PVR proves to be a reliable and cost-effective tool for assessing bone regeneration in different bone transport techniques, offering potential for guiding clinical decision-making. These findings suggest that trifocal transport should be considered as a preferred method for treating larger bone defects, especially when minimizing treatment time is crucial.

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来源期刊

Frontiers in Surgery Medicine-Surgery

CiteScore

1.90

自引率

11.10%

发文量

1872

审稿时长

12 weeks

期刊介绍： Evidence of surgical interventions go back to prehistoric times. Since then, the field of surgery has developed into a complex array of specialties and procedures, particularly with the advent of microsurgery, lasers and minimally invasive techniques. The advanced skills now required from surgeons has led to ever increasing specialization, though these still share important fundamental principles. Frontiers in Surgery is the umbrella journal representing the publication interests of all surgical specialties. It is divided into several “Specialty Sections” listed below. All these sections have their own Specialty Chief Editor, Editorial Board and homepage, but all articles carry the citation Frontiers in Surgery. Frontiers in Surgery calls upon medical professionals and scientists from all surgical specialties to publish their experimental and clinical studies in this journal. By assembling all surgical specialties, which nonetheless retain their independence, under the common umbrella of Frontiers in Surgery, a powerful publication venue is created. Since there is often overlap and common ground between the different surgical specialties, assembly of all surgical disciplines into a single journal will foster a collaborative dialogue amongst the surgical community. This means that publications, which are also of interest to other surgical specialties, will reach a wider audience and have greater impact. The aim of this multidisciplinary journal is to create a discussion and knowledge platform of advances and research findings in surgical practice today to continuously improve clinical management of patients and foster innovation in this field.