Value of ultrasonography for observation of early healing of humeral shaft fractures.

PURPOSE: Explore the value of ultrasonography for observation of early healing of humeral shaft fractures. METHODS: Sixty-five humeral shaft fracture patients were recruited. They were examined sonographically with color Doppler ultrasonography (CDU) and/or power Doppler ultrasonography (PDU) during the 1st week, 2nd week, 3rd week, 4th week, 9th week, and 15th week after the initial surgical procedure of internal fixation. Formation of callus consolidation and the resistance indexes (RI) of blood flow in different durations were compared between the good healing group and bad healing (delayed fracture healing or nonunion) group. RESULTS: Ultrasound showed that 59 patients had good fracture healing. Within the 2nd and 4th week after surgery, the RI decreased over time (P < 0.05) and color Doppler flow imaging (CDFI/PDU) grading ranged from II to III. Six patients had bad fracture healing (delayed healing or nonunion). Insufficient or absent blood flow signals demonstrated that no callus was found in and/or around the fracture sites. CDFI grading ranged from 0 to I. There was significant difference compared with the good healing group (P < 0.05). CONCLUSION: CDFI/PDU is an easy, painless, and effective method for predicting the prognosis of humeral shaft fractures by estimating early healing.

[Treatment of intra-articular calcaneal fractures by minimally invasive through the sinus tarsi approach and external fixation with calcaneal locking plates].

OBJECTIVE: To investigate the clinical results and the superiority of minimally invasive sinus tarsi approach andABSTRACT Objective :To investigate the clinical results and the superiority of minimally invasive sinus tarsi approach and external fixation with calcaneal locking plates for the treatment of the intra-articular calcaneal fracture. METHODS: From July 2011 to August 2012, 12 cases (13 feet) were treated by sinus tarsi approach and external fixation with calcaneal locking plates. There were 10 males and 2 females, aged from 25 to 48 years old (means 35 years old). According to Sanders classifi- cation system, there were 7 feet with type II, 6 feet with type III. The Böhler angle and Gissane angle were compared before and after operation. The clinical results were evaluated with the Maryland foot score system. RESULTS: All 12 cases were followed up from 6 to 14 months (means 10 months). There were no incision complications. Fracture healing time was from 3 to 6 months (means 4 months). The Böhler angle increased from preoperative (11.19 +/- 5.69) degrees to postoperative (30.13 +/- 7.52) degrees; The Gissane angle increased from preoperative (108.31 +/- 10.35) degrees to postoperative (118.99 +/- 8.94) degrees. According to Maryland foot score system, 8 feet got an excellent result, 3 good, 2 fair. CONCLUSION: Open reduction by sinus tarsi approach and external fixation with calcaneal locking plates is an effective method for treatment of Sanders II, III calcaneal fracture. It can obtain good reduction and stable fixation with minimal invasion and lower complications.