Real time ultrasound guided closed reduction of nasal bone fracture / 中国医学影像技术

Objective: To explore the clinical value of real-time ultrasound-guided closed reduction of nasal bone fracture. Methods: Sixty patients with clinically confirmed nasal bone fractures were randomly divided into experimental group and control group (each n=30). Both groups were treated with closed reduction of nasal bone fracture under general anesthesia. Patients in experimental group were treated with real-time ultrasound-guided closed reduction, while those in control group were treated with closed reduction of nasal bone fracture under traditional visual and palpation. After reduction, effect of reduction was evaluated with three-point method based on nasal CT scan. The second reduction rates, hospitalization time and post-operative CT scores were compared between the two groups. Results: The second reduction rate of fracture was 0 in the experimental group, whereas 13.33% (4/30) in control group (χ2=4.286, P=0.038).The hospitalization time of experimental group was 4 days, of control group was 5 days (Z=-5.024, P<0.001). The scoring of experimental group were 3 points and 2 points respectively in 19 cases and 11 cases, while of control group were 3 points in 11 cases, 2 points in 16 cases and 1 point in 3 cases. The reduction effect of experimental group was better than that of control group (χ2=6.059, P=0.048). Conclusion: Real-time ultrasound-guided closed reduction of nasal bone fracture is accurate and reliable, which can reduce the risk of second reduction of fracture and avoid X-ray radiation, also effectively shorten the hospitalization time of patients and improve the satisfaction of both doctors and patients.

Intra- and Inter-rater Reliability of Shear Wave Elastic Imaging Technique for Elastic Modulus Measurements of Muscle and Tendon / 中国康复理论与实践

@#Objective To explore the intra- and inter-rater reliability of shear wave elastography (SWE) for the patellar tendon and quadriceps femoris stiffness.Methods From October to November, 2017, the stiffness of the patellar tendon and quadriceps femoris of 20 healthy men was measured by SWE, and measured again five days later. The results were evaluated with interclass correlation coefficient (ICC).Results For patellar tendon, ICC=0.79 in intra-rater and inter-rater; for rectus femoris, ICC=0.71 in intra-rater and 0.73 in inter-rater; for vastus lateralis muscle, ICC=0.84 in intra-rater and 0.74 in inter-rater; for vastus medialis,ICC=0.95 in intra-rater and 0.94 in inter-rater.Conclusion It is a reliable and repeatable method to measure the stiffness of patellar tendon and quadriceps femoris by SWE.

Ultrasound-guided minimal invasive fixation for metacarpus and phalange fractures / 中国医学影像技术

Objective To explore value of high-frequency ultrasound-guided minimally invasive fixation treatment for metacarpus and phalange fractures.Methods Totally 26 patients of acute metacarpus and phalange fractures were selected and randomly divided into experimental group and control group (each n =13).The patients in experimental group underwent ultrasound-guided closed reduction,while in control group underwent C-arm X-ray fluoroscopy-guided reduction.Then the patients in two groups were followed up,and the curative effect of both methods were observed.Results The successful rate of closed reduction was 76.92％ (10/13) in experimental group,while was 84.62％ (11/13) in control group (x2=0,P=1.00).C-arm fluoroscopy was performed (0.62±1.19) times in experimental group,and (3.46±0.78) times in control group (t=-7.21,P＜0.01).The average healing time of fracture was (5.45±0.64) weeks in experimental group and (5.71±0.78) weeks in control group.The excellent and good rate of total active motion (TAM) was 84.62％ (11/13) in experimental group and 92.31％ (12/13) in control group,respectively.The average grip strength was (32.22±2.44) kg in experimental group,and (34.11±2.74) kg in control group (all P＞0.05).Conclusion High frequency ultrasound-guided minimally invasive fixation is reliable in treatment of metacarpal and phalangeal fractures,which can significantly reduce X-ray radiation.

Progresses of ultrasound-guided closed reduction and minimally invasive fixation of limb fractures / 中国医学影像技术

The treatment of limb fractures with closed reduction and minimally invasive fixation with C-arm or conventional X-ray guidance has been widely accepted and gradually developed due to less trauma and rapid healing.However,the radiation damage of X-ray can not be ignored.With the continuous progresses of ultrasound technology,the application of ultrasound in clinic is involved not only in the diagnosis of fractures,but also in the closed reduction and fixation of fractures.The research progresses of ultrasound-guided closed reduction and minimally invasive fixation of limb fractures were reviewed in this article.