Decreased Radiation Exposure Using Ultrasound-Assisted Reduction and Fixation of Femoral Shaft Fractures in Children: A Pilot Study

Wu, Zhiping; Yi, Xianhong; Li, Yuan; Mao, Chenghuang; Wang, Wei; Yan, Guangkui; Fang, Mingchu; Pan, Tianlong; Zhu, Ruibo; Zhang, Jingdong

doi:10.1016/j.ultrasmedbio.2020.07.026

Cited by 8 publications

(5 citation statements)

References 21 publications

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“…The transmission of pain requires the ventral nucleus of the primary sensory ganglia, spinal dorsal horn, and dorsal thalamus to reach the cerebral cortex, and nerve block is to allow drugs to act directly on sensory nerves in a part of the body to block the transmission of pain excitability, so that pain signals cannot be transmitted to the center, which in turn reduces pain [ 24 , 25 ]. It found that the VAS scores at 1, 5, 10, and 15 after surgery in the routine group were significantly higher than those in the experimental group, and the difference was statistically significant ( P < 0.05).…”

Section: Discussionmentioning

confidence: 99%

Effect of Low-Dose Dexmedetomidine Combined with Lumbosacral Plexus Block Guided by Ultrasound Imaging Based on Image Segmentation Algorithm in Fracture Surgery

Wang

He³

et al. 2022

Computational Intelligence and Neuroscience

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The aim of this study was to analyze the application of ultrasound-guided low-dose dexmedetomidine combined with lumbosacral plexus block based on artificial intelligence algorithm in the surgical treatment of proximal femoral fractures. 104 patients with proximal femoral fractures were divided into 52 cases in the experimental group (ultrasound-guided lumbosacral plexus block combined with dexmedetomidine based on local fitting image segmentation algorithm) and 52 cases in the routine group (endotracheal intubation and inhalation combined with general anesthesia). An image segmentation algorithm based on local fitting was constructed to enhance the ultrasound image. It was found that in the routine group, the heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) at the beginning of intravenous injection of dexmedetomidine, during skin incision, and half an hour after skin incision were significantly lower than those at admission ( P < 0.05 ). The pressing times of patient-controlled intravenous analgesia (PCIA) in the conventional group (17.05 ± 6.85 times) were significantly higher than that in the experimental group (8.55 ± 4.12 times), and the difference was statistically significant ( P < 0.05 ). The visual analogue scale (VAS) scores at 1, 5, 10, and 15 after operation in the routine group were significantly higher than those in the experimental group ( P < 0.05 ). The number of dizziness, nausea, and vomiting, venous thrombosis of lower limbs, cardiovascular events, and pulmonary infection in the routine group on the 1st, 2nd, and 3rd days after operation were significantly higher than those in the experimental group ( P < 0.05 ). In summary, the ultrasound-guided lumbar plexus-sacral plexus block combined with dexmedetomidine anesthesia based on image segmentation algorithm can effectively maintain the hemodynamic stability of patients, with remarkable analgesic effect and high safety.

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Section: Discussionmentioning

confidence: 99%

Effect of Low-Dose Dexmedetomidine Combined with Lumbosacral Plexus Block Guided by Ultrasound Imaging Based on Image Segmentation Algorithm in Fracture Surgery

Wang

He³

et al. 2022

Computational Intelligence and Neuroscience

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“…Because of its multiplanar real-time imaging capabilities, costeffectiveness, mobility, and lack of radiation exposure, US is increasingly employed in musculoskeletal system examinations (20,21). In a study of 201 children with forearm fractures, US had a sensitivity and specificity of 99.5% in identifying fractures (22).…”

Section: Discussionmentioning

confidence: 99%

Elastic Stable Intramedullary Nailing for Pediatric Humeral Shaft Fractures Under Ultrasonographic Guidance: A Retrospective Study

Zhang

et al. 2022

Front. Pediatr.

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ObjectiveFixation with an elastic stable intramedullary nail (ESIN) is a widely used technique for the treatment of humeral shaft fractures. Ultrasonography (US) is used as an auxiliary tool and alternative to radiography during surgery to reduce radiation damage, but whether it is effective in pediatric patients is not known. In this study we evaluated the utility of US in the treatment of pediatric humeral shaft fractures by closed reduction and fixation with an ESIN.MethodsChildren who were admitted to our hospital with humeral shaft fractures were retrospectively examined from January 2016 to March 2019. The patients were divided into 2 groups, US (treated by US-guided closed reduction and ESIN fixation) and non-US (treated with the same technique but with intraoperative radiography instead of US). The postoperative functional recovery of the 2 groups was compared.ResultsThe study population comprised 28 boys and 17 girls (age range: 4–16 years) with humeral shaft fractures. US significantly reduced radiation exposure during the operation (P = 0.008), and intraoperative US facilitated the detection of nerve and vascular injury and aided surgical planning. There was no difference between the 2 groups in postoperative recovery based on the Constant–Murley shoulder score (CMS).ConclusionsThese results demonstrate that US-guided closed reduction and ESIN fixation for humeral shaft fractures can limit radiation exposure and help doctors to determine the optimal surgical strategy to avoid radial nerve injury.

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“…Ultrasonography was originally used for soft tissue examination, as its real-time imaging, multiplanar capabilities, cost-effectiveness, portability, patient comfort and absence of radiation exposure, ultrasonography was widely used in musculoskeletal system examination [14,15]. HERREN et al[16] used ultrasound to examine 201 children with forearm fractures, the sensitivity and speci city of diagnosing fractures were higher than 99.5%.…”

Section: Discussionmentioning

confidence: 99%

Application of Ultrasonography in Conservative Treatment of Humeral Shaft Fracture in Children

Tan

et al. 2021

Preprint

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Background: Most of humeral shaft fractures in children could be treated satisfactorily by conservative treatment. This study aimed to evaluate the application value of ultrasonography in conservative treatment of humeral shaft fracture in children.Methods: We retrospectively reviewed children admitted to our hospital, for humeral shaft fracture from January 2014 to March 2018. The patients were divided into two groups: ultrasonography group and X-ray group. All patients were instructed to evaluat the prognosis according to the Disabilities of Arm, Shoulder and Hand (DASH) score at 12 months.Results: A total of 37 children were divided into ultrasonography group, 32 children were divided into X-ray group. There was no significant difference in DASH between the two groups. The mean number of radiation exposures of ultrasonography group was less and ultrasonic examination found radial nerve injury, and using ultrasound reduced the chance of direct or in direct contact with infected peoples.Conclusions: Ultrasound is a non-invasive, non-radioactive test, which could decrease risk of COVID-19 infection and detect the vascular nerve injury caused by fracture. Ultrasonography may be the examination method for follow-up conservative treatment of humeral shaft fracture in children during the epidemic period.

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Decreased Radiation Exposure Using Ultrasound-Assisted Reduction and Fixation of Femoral Shaft Fractures in Children: A Pilot Study

Cited by 8 publications

References 21 publications

Effect of Low-Dose Dexmedetomidine Combined with Lumbosacral Plexus Block Guided by Ultrasound Imaging Based on Image Segmentation Algorithm in Fracture Surgery

Effect of Low-Dose Dexmedetomidine Combined with Lumbosacral Plexus Block Guided by Ultrasound Imaging Based on Image Segmentation Algorithm in Fracture Surgery

Elastic Stable Intramedullary Nailing for Pediatric Humeral Shaft Fractures Under Ultrasonographic Guidance: A Retrospective Study

Application of Ultrasonography in Conservative Treatment of Humeral Shaft Fracture in Children

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