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Research project  |  Sonographic Tissue Evaluation of Regenerate in Children During Limb Lengthening

STRETCH

A prospective cohort study evaluating advanced ultrasound imaging to assess bone regenerate quality during pediatric limb lengthening, aiming to optimise lengthening, reduce radiation exposure and improve patient‑centred care.

What we do

About our project

Limb lengthening can significantly improve mobility and quality of life but involves an intensive treatment period including frequent radiographic monitoring.

Recent technological advances enable ultrasound‑based structural bone analysis and vascularisation, providing a radiation‑free alternative to assess regenerate formation. Given the largely non-ossified nature of the new bone formation, ultrasound can provide a more detailed assesment of this regenerate.  

The STRETCH study integrates novel quantitative ultrasound biomarkers with clinical radiography to monitor bone architecture, consolidation and mineralization.

This project aims to improve patient safety, reduce radiation burden and optimize decision‑making during distraction osteogenesis for children and families.
 

Our research focus

We apply high‑resolution ultrasound to quantify cortical bone structure, using speed‑of‑sound measurements sensitive to anisotropy and mineralization.

We compare ultrasound biomarkers with conventional radiographic metrics of regenerate and callus formation.

We evaluate factors influencing regenerate maturation, including distraction rate, fixation method, underlying pathology and patient‑specific healing profiles.

Our goal is to develop evidence‑based, personalized lengthening and follow‑up strategies that optimize treatment safety and efficiency while reducing treatment burden and radiation exposure.
 

Funds & Grants

This study is funded by the: 

EPOS research grant & Erasmus MC foundation – Orthopedic surgery and European Pediatric Orthopedic Scoiety (EPOS) 2025 research grant

 

Collaborations

TU Delft, department of imaging physics

Our team