Application of ultrasound in monitoring changes in quadriceps muscle parameters and hemodynamics in patients with distal leg fractures

Abstract

Objective To measure the morphological parameters of the quadriceps (rectus femoris, medial femoral muscle, lateral femoral muscle, and medial femoral muscle) and the changes in hemodynamic parameters of the lower extremity femoral artery in patients with distal extremity fractures by ultrasound and to explore the relationship between these parameters and the disuse muscle atrophy and provide reference for early clinical rehabilitation. Methods Twenty patients with distal extremity fractures requiring bed rest who were treated at Kunshan Zhoushi people′s Hospital from May 2018 to May 2019 were included. Both the affected side and the healthy side were observed. The rectus femoris thickness and area, quadriceps thickness, and femoral artery blood flow spectrum parameters of the lower extremities were repeatedly measured by ultrasound on the first, fourth, seventh, and tenth days since hospital admission to observe the changes in these data over time. The femoral artery blood flow spectrum parameters on day 1 were also compared with those on day 10. Results Compared with the healthy side, the affected side had significantly decreased rectus femoris thickness and area (t=4.436, 11.506, 2.175, 5.902, 11.784, 5.949, 16.620, 14.069, 4.904, 5.726, and 9.787, P<0.05), lateral femoral muscle thickness (t=4.682, 5.978, 4.133, 4.608, and 7.092, P<0.05), medial femoral muscle thickness (t=3.784, 5.669, 3.916, 10.128, and 12.271, P<0.05), and medial femoris thickness (t=7.166, 3.443, 4.983, 2.978, all P<0.05), suggesting that muscle atrophy occurred in the affected side. The atrophy occurred earliest on the 4 th day after the ipsilateral medial femoral muscle was braked. In the early diastolic phase, the reverse blood flow velocity on day 10 was significantly reduced compared with that on day 1 and the duration of reverse blood flow was significantly shortened (t=5.337, 3.246, 3.604, and 2.484, P<0.05). When comparing the parameters of the affected femoral artery among the four time points, the peak velocity in the systolic phase, the reverse blood flow velocity in the early diastolic phase, and the duration of the reverse blood flow in the early diastolic phase all decreased significantly (t=2.633, 4.711, 5.337, 4.681, 3.246, 4.574, 2.973, 3.604, 2.484, and 2.484, P<0.05). Conclusion Ultrasound can assess muscle atrophy by monitoring the changes in muscle thickness and hemodynamic changes. Key words: Quadriceps; Muscle thickness; Muscle atrophy; Ultrasound; Hemodynamics