OBJECTIVE:The assessment of fracture union includes physical examination and radiographic imaging, which depend on the examiner's experience. The development of ancillary methods may avoid prolonged treatments and the improper removal of implants. Quantitative bone ultrasonometry has been studied for this purpose and will soon be included in clinical practice. The aims of the present study were to assess the feasibility of using this technique on the clavicle and to standardize its in vivo application.METHODS:Twenty adult volunteers, including 10 men and 10 women without medical conditions or a previous history of clavicle fracture, underwent axial quantitative ultrasonometric assessment using transducers in various positions (different distances between the transducers and different angulations relative to the clavicle).RESULTS:Similar values of wave propagation velocity were obtained in the different tested set-ups, which included distinct distances between the transducers and angular positions relative to the clavicle. There were significant differences only in the transducers positioned at 0° and at 5 or 7 cm apart.CONCLUSIONS:The use of bone ultrasonometry on the clavicle is feasible and the standardization of the technique proposed in this study (transducers placed at 45° and at 7 cm apart) will allow its future application in clinical trials to evaluate the healing process of diaphyseal fractures of the clavicle.
Objective To assess and report clinical data from patients with syndactyly. Methods A retrospective review of 47 patients treated between April 2002 and April 2012. Results Among the 47 analyzed patients, 33 (70%) were male and 14 (30%) female. The total number of syndactylies was 116. The right hand was affected in 19 patients (40%), the left hand in 12 (24%) and 31 (36%) were bilaterally compromise. Sixteen patients (34%) also presented genetic syndromes. Among the 31 (66%) patients without syndromes, 12 (39%) had isolated syndactyly and 19 (61%) presented association with other hand anomalies. The third web space was affected 45 (39%) times; the fourth, 35 (30%) times; the second, 22 (19%) times and the first web space 14 (22%) times. Simple syndactyly was found 68 (59%) times, complete syndactyly in 44 (65%) and incomplete in 24 (55%). Complex syndactyly was found 48 (41%) times. Conclusion The results in this study are similar to the literature. Epidemiological Study.
Objective: To analyze the influence of steel plates for osteosynthesis on the velocity of ultrasound propagation (VU) through the bone. Methods: The transverse coronal and sagittal velocity of ultrasound propagation underwater were measured on the intact bone and then on assemblies of the same bone with two types of osteosynthesis plates (DCP and semi tubular), fixed onto the dorsal side of the bones. The first arriving signal (FAS) was the ultrasound parameter used, taking the coronal and sagittal diameters as the distances to calculate velocity. Intergroup statistical comparisons were made at significance level of 1% (p<0.01). Results: Velocity was higher on the intact bones than on the bone-plate assemblies and higher for the semitubular than for the compression plates, although differences were not statistically significant for most comparisons (p=0.0132 to 0.9884), indicating that the steel plates do not interfere significantly with ultrasound wave propagation through the bone-plate assemblies. Conclusion: The velocity reduction effect was attributed to the greater reflection coefficient of the steel as compared to that of bone and water. Ultrasonometry can, thus, be used in the evaluation of healing of fractures fixed with steel plates. Experimental Study.
ObjectiveAn experimental in vitro study was carried out to evaluate the influence of cortical bone thickness on ultrasound propagation velocity.MethodsSixty bone plates were used, made from bovine femurs, with thickness ranging from 1 to 6 mm (10 of each). The ultrasound velocity measurements were performed using a device specially designed for this purpose, in an underwater acoustic tank and with direct contact using contact gel. The transducers were positioned in two ways: on opposite sides, with the bone between them, for the transverse measurement; and parallel to each other, on the same side of the bone plates, for the axial measurements.ResultsIn the axial transmission mode, the ultrasound velocity speed increased with cortical bone thickness, regardless of the distance between the transducers, up to a thickness of 5 mm, then remained constant thereafter. There were no changes in velocity when the transverse measures were made.ConclusionUltrasound velocity increased with cortical bone thickness in the axial transmission mode, until the thickness surpasses the wavelength, after which point it remained constant. Level of Evidence: Experimental Study.
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