Chachan Sourabh, Tudu Barsha, Sahu Biswajit
Department of Orthopaedics, Veer Surendra Sai Medical College, Sambalpur, India.
J Orthop Trauma. 2015 Mar;29(3):e133-8. doi: 10.1097/BOT.0000000000000207.
To compare the efficacy of ultrasonography (US) versus radiography (XR) in monitoring fracture healing.
Prospective diagnostic follow-up study.
Department of Orthopaedics, Level II trauma center.
Forty-eight acute closed tibial mid diaphysis fracture (OTA 42-A and B) treated by closed reduction and internal fixation with a reamed statically locked tibial interlocking nail between October 2011 and October 2012.
Evaluation of fracture healing using both US and XR at 2 week intervals.
Ultrasonographic criterion for fracture healing was set as progressive appearance of periosteal callus along with progressive decrease in visibility of nail. Radiographic criterion for fracture union was set as the appearance of bridging callus across all 4 cortices.
Thirty-eight of 48 fractures achieved union, 6 developed a delayed union, whereas 4 went onto nonunion. It was observed that using the above-stated criteria, fracture union was diagnosed at an average of 2 weeks earlier with US as compared with XR. Four of the 6 delayed unions and all nonunions declared themselves much earlier on US versus XR.
Ultrasonography can provide valuable early information about union and predict delayed and nonunions at an earlier time interval than standard plain radiographs.
Diagnostic level II. See Instructions for authors for a complete description of levels of evidence.
比较超声（US）与X线摄影（XR）监测骨折愈合的疗效。
前瞻性诊断随访研究。
二级创伤中心骨科。
2011年10月至2012年10月间，48例急性闭合性胫骨干中段骨折（OTA 42 - A和B型）患者，采用闭合复位和带锁髓内钉内固定治疗。
每隔2周使用超声和X线摄影评估骨折愈合情况。
骨折愈合的超声标准设定为骨膜骨痂逐渐出现且髓内钉显影逐渐减弱。骨折愈合的X线标准设定为跨越所有4层皮质出现桥接骨痂。
48例骨折中有38例达到愈合，6例出现延迟愈合，4例发生不愈合。观察发现，使用上述标准，与X线摄影相比，超声平均提前2周诊断骨折愈合。6例延迟愈合中的4例以及所有不愈合病例，超声诊断比X线摄影更早。
与标准平片相比，超声能够提供有关骨折愈合的有价值的早期信息，并能在更早的时间间隔预测延迟愈合和不愈合。
诊断性II级。有关证据级别的完整描述，请参阅作者指南。
