Ultrasound for the Early Diagnosis of Tibial Fracture Healing After Static Interlocked Nailing Without Reaming: Clinical Results

Abstract

The results of this study indicate that US may provide important prognostic information concerning fracture healing after unreamed tibial nailing, upon which subsequent treatment can be based.

The effect of ultrasound on the healing of muscle-pediculated bone graft in scaphoid non-union

“…The use of ultrasound as a surgical instrument involves even higher levels of intensity (5-300 W/cm 2 ), and sharp bursts of energy are used to fragment calculi, to initiate the healing of non-unions, to ablate diseased tissues such as cataracts, and even to remove methylmethacrylate cement during revision of prosthetic joints [8]. At the opposite end of the ultrasound-intensity spectrum, much lower magnitudes of 1-50 mW/cm 2 are used to drive diagnostic devices that non- invasively image vital organs, foetal development, peripheral blood flow, and metabolic bone diseases such as osteoporosis and to evaluate fracture callus during healing [9,10]. The intensity level used for imaging, which is five orders of magnitude below that used for surgery, is regarded as nonthermal and nondestructive [11].…”

The use of 18F-fluoride and 18F-FDG PET scans to assess fracture healing in a rat femur model

“…Moreover, CT scans demonstrate low specificity in the diagnosis of fracture nonunions in long bones [15,16]. The use of ultrasound technology has also been studied in the evaluation of bony healing in certain fractures [17][18][19][20][21], but because surgeons typically do not have experience evaluating ultrasound images, it has not been routinely used in the diagnosis of delayed fracture healing.…”

“…PET imaging has historically been used to characterize malignant and benign tumors, and recent studies have utilized PET technologies with novel tracers to measure skeletal metabolic activity. 18 F-fluoride ion, a positron-emitting isotope, has been shown to deposit preferentially at the surface of bone, where the greatest activity of remodeling and turnover are seen [32,33]. 18 F-fluoride ion exchanges with hydroxyl groups on hydroxyapatite to form fluoroapatite, which subsequently incorporates into the formation of bone matrix [33,34].…”

“…18 F-fluoride ion, a positron-emitting isotope, has been shown to deposit preferentially at the surface of bone, where the greatest activity of remodeling and turnover are seen [32,33]. 18 F-fluoride ion exchanges with hydroxyl groups on hydroxyapatite to form fluoroapatite, which subsequently incorporates into the formation of bone matrix [33,34]. The uptake of 18 Ffluoride tracer correlates with skeletal blood flow and has been shown to exhibit superior pharmacokinetic properties compared to 99m Tc-labeled biphosphonates [35][36][37][38][39][40].…”

“…While metabolic activity quantification methods using 99m Tc-labeled compounds have been unsuccessful [41], recent uses of 18 F-fluoride ion include the measurement of regional bone metabolism in metastatic musculoskeletal tumors, osteoporosis, and Paget's disease [42][43][44][45]. 18 F-fluorodeoxyglucose (FDG) has classically been used in PET imaging as a screening tool in characterizing the spread of malignant tumors [46]. Uptake of 18 F-FDG is seen in areas of increased cellular glucose metabolism and serves as a marker for localized metabolic activity.…”