Quantification of bone thickness and morphology in fractured tibias using computed radiography

Computed Radiography image acquisition, processing and analysis techniques have been developed to allow extraction of objective and quantitative measures of bone thickness and morphology from serially acquired images in patients treated for diaphyseal tibia fractures using either intramedullary nails or Ilizarov frames. Monte Carlo techniques have been used to simulate the imaging process and to allow the development and testing of scatter removal algorithms followed by decomposition of the image into bone only and soft tissue only images. Fracture gap and periosteal callus bone thickness have been determined for both treatment regimes at a number of time points post surgery and display changes consistent with the regeneration and remodelling of bone. A novel parameter, based upon image fractal dimension, has been developed and used to characterize morphological aspects of the fracture gap with changes observed being consistent with an increased uniform distribution of bone in the fracture gap.