Department of Biomechanics, Medicine and Rehabilitation of the Locomotor Apparatus, Ribeirão Preto School of Medicine, São Paulo University, São Paulo, Brazil.
J Orthop Res. 2011 Mar;29(3):444-51. doi: 10.1002/jor.21258. Epub 2010 Sep 29.
Ultrasonometry seems to have a future for the evaluation of fracture healing. Ultrasound propagation velocity (USPV) significantly decreases at the same time that bone diameter decreases as healing takes place, thus approaching normal values. In this investigation, both USPV and broadband ultrasound attenuation (BUA) were measured using a model of a transverse mid-diaphyseal osteotomy of sheep tibiae. Twenty-one sheep were operated and divided into three groups of seven, according to the follow-up period of 30, 60, and 90 days, respectively. The progress of healing of the osteotomy was checked with monthly conventional radiographs. The animals were killed at the end of the period of observation of each group, both operated-upon and intact tibiae being resected and submitted to the measurement of underwater transverse and direct contact transverse and longitudinal USPV and BUA at the osteotomy site. The intact left tibia of the 21 animals was used for control, being examined on a symmetrical diaphyseal segment. USPV increased while BUA decreased with the progression of healing, with significant differences between the operated and untouched tibiae and between the periods of observation, for most of the comparisons. There was a strong negative correlation between USPV and BUA. Both USPV and BUA directly reflect and can help predict the healing of fractures, but USPV alone can be used as a fundamental parameter. Ultrasonometry may be of use in clinical application to humans provided adequate adaptations can be developed.
超声检查似乎在评估骨折愈合方面有一定的前景。在愈合过程中,随着骨直径的减小,超声传播速度(USPV)显著降低,接近正常值。在这项研究中,使用绵羊胫骨横断骨髓内切开模型测量了 USPV 和宽带超声衰减(BUA)。21 只羊接受了手术,并根据 30、60 和 90 天的随访期分为三组,每组 7 只。每月进行常规 X 线检查以检查切开处的愈合进展情况。在每组观察期结束时,处死动物,切除手术和未手术的胫骨,并在切开部位测量水下横切、直接接触横切和纵切 USPV 和 BUA。21 只动物的完整左侧胫骨用作对照,在对称的骨干段进行检查。随着愈合的进展,USPV 增加,BUA 降低,大多数比较中,手术和未手术的胫骨之间以及观察期之间均有显著差异。USPV 和 BUA 之间存在强烈的负相关。USPV 和 BUA 都可以直接反映并有助于预测骨折愈合,但单独使用 USPV 可以作为基本参数。如果能开发出适当的适应方法,超声检查可能在人类的临床应用中有用。