Department of Orthopaedic Surgery, Boston University Medical Center, Doctors Office Building, Suite 808, 720 Harrison Avenue, Boston, MA 02118, USA.
Injury. 2011 Mar;42(3):301-5. doi: 10.1016/j.injury.2010.11.043. Epub 2010 Dec 9.
Fracture healing is an optimized biological process yet the ability to determine when a fracture is healed, or to measure the healing response can present a clinical challenge. This review will focus on the evidence for the implementation of imaging modalities as tools to assist in evaluating fracture union. This is particularly important for common fractures that have a propensity to have delayed union or non-union, where a diagnosis of non-union would alter the treatment. We also present methods, such as biochemical markers and clinical scores that are in development or have the potential to aid in the diagnosis of non-union. Ultimately, clinical exam combined with the available modalities can help the clinician judge the progression of healing with some confidence. There is still a need for continued development of new modalities and tests to improve accuracy of the diagnosis of non-union, as well as predict which fractures are at risk for non-union.
骨折愈合是一个优化的生物学过程，但确定骨折何时愈合，或衡量愈合反应的能力可能是一个临床挑战。本综述将重点介绍影像学方法作为辅助评估骨折愈合的工具的证据。这对于容易发生延迟愈合或不愈合的常见骨折尤为重要，因为不愈合的诊断会改变治疗方法。我们还介绍了一些方法，如生化标志物和临床评分，这些方法正在开发中或有可能有助于诊断不愈合。最终，临床检查结合现有的检查方法可以帮助临床医生有一定把握地判断愈合的进展。仍然需要不断开发新的方法和测试来提高不愈合诊断的准确性，并预测哪些骨折有发生不愈合的风险。
