Noninvasive determination of bone stiffness for distraction osteogenesis by quantitative computed tomography scans.

Apparent density of canine tibial specimens was correlated to measured quantitative computed tomography (QCT) numbers, and a conversion equation was derived. Finite element analysis models of canine tibiae were constructed using spatial coordinates of converted QCT data. Two QCT-derived finite elemental analysis models were constructed for a pair of matched tibiae: one lengthened 15% by distraction osteogenesis and one contralateral control. Two equations relating the modulus of elasticity to apparent density were used. These models were then verified mechanically by measuring strains of the two specimens under applied load. Equation I correlated best with measured strains in the less-dense regenerate bone of the distracted tibia (R2 = 0.914, p = 0.0028, n = 6); Equation II performed best in the denser control tibia (R2 = 0.820, p = 0.0129, n = 6). These results demonstrate that the stiffness of tubular bones, including cortical and heterogenous cancellous structure, can be accurately predicted by a noninvasive QCT scan.