The assessment of fracture healing is aided by identifying features in roentgenographs that signify bone union. In comminuted or multi-part fractures, external callus formation relates to mechanical rigidity at the fracture site.[1] However, inter- and intra-observer variability of 20–25% exists when physicians evaluate callus.[2] Furthermore, current classification systems lose information by converting continuous features into categorical variables.[3] These limitations have restricted the clinical utility of plain radiographs in retrospective evaluation of treatment course.[4,5] Image processing presents a viable means to reduce observer error, while yielding continuous results. The aim of this work was to verify, numerically and clinically, an objective method to quantify callus formation.

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