Revista de la Asociación Argentina de Ortopedia y Traumatología
versión On-line ISSN 1852-7434
PAGANINI, Federico; ALLENDE, Christian y MARCHEGIANI, Silvio. Value of ultrasound to diagnose fracture Healing and non-union. Rev. Asoc. Argent. Ortop. Traumatol. [online]. 2010, vol.75, n.1, pp. 82-87. ISSN 1852-7434.
Background: to determine the value of ultrasound in fracture healing and non-union, and correlate radiographic and ultrasonographic images. Methods: a prospective paper evaluating 22 patients with 24 fractures and six non-unions in long bone metaphyses. We included patients of both sexes, with closed growth plates. We comparatively evaluated the degree of callus formation in each of the faces with x-rays and ultrasound at 3, 6, and 8 weeks, and at 3 and 5 months. To do this we divided each bone in faces and each face in zones (-1, 0, A, B, C) according to the degree of bone formation. A statistical analysis was run to assess the validity (sensitivity and specificity) and safety (positive and negative predictive value) of ultrasound, and correlate it with x-rays (Kappa index). Results: in fractures, concordance was minor in the first weeks, but at five months we observed good concordance (kappa = 0.6). Sensitivity grew in time while specificity remained similar throughout the controls. As for nonunions, patients were very few; sensitivity grew up to the third month while specificity decreased. There was no concordance in the first or last controls (Kappa = 0). Conclusions: ultrasounds is an excellent diagnostic method; nevertheless it has precise indications and we consider that its use in the follow up of fracture healing and non-union processes has shown little diagnostic and predictive value. Therefore we think that radiology continues to be the "gold standard" for the evaluation of the above mentioned processes.
Palabras llave : Ultrasound; Bone formation; Fractures; Non-unions.