[The echographic follow-up of patients treated with an external fixator in childhood and adolescence]. / Controllo ecografico di pazienti trattati con fissatore esterno nell'età pediatrica e giovanile.

ABSTRACT

In the last few years external fixation has started to be extensively used in pediatric orthopedics and traumatology and ultrasound (US) monitoring has been adopted. The role of US was investigated in a study on 64 patients aged 2 to 30 years treated from November, 1989, to December, 1993. Some patients underwent several interventions with different methods and therefore belong to more than one of the three considered groups. In case of surgical lengthening (group A), the role of US was investigated in a study on 54 patients aged 2 to 26 years. The following variables were studied with US diastasis entity, stump axis and the evolution of regenerated tissue within 10 days of the beginning of lengthening (first follow-up), at 20 days (second follow-up) and at 30 days (third follow-up). Ilizarov and Wagner fixators and one external fixation reduction fixator were used on 54 patients in 83 segments (43 femurs, 39 tibias and 1 humerus). In all, 104 corticotomies were performed. In fractures treated with external fixators (group B), US allowed the study of the hematoma surrounding the lesion and of its progressive evolution from fibrous tissue to bone callus, within 30 days of external fixation (first follow-up), at 60 days (second follow-up) and at 90 days (third follow-up). Eight patients were treated. The segments treated were 9 femurs and 2 tibias, 11 fixators in all. Patients age ranged 9 to 19 years. Five patients underwent corrective osteotomies with external fixators (group C), in which group US follow-up exams were not standardized. For all 252 US examinations, performed in real time, an Acuson 128 unit with a 5-MHz linear probe was used and anterior, median and lateral longitudinal scans were acquired.