Bone fracture and the healing mechanisms. A new method for evaluation of fracture healing by echo tracking

Abstract

Assessment of bone healing on radiographs is not necessarily objective. A clinical system was developed to quantify the stiffness of healing fractures of the tibia in patients by the echo tracking (ET) method in a manner similar to a three-point bending test. The lower leg was supported. An ultrasound probe was placed on the proximal and distal fragments and a load of 25 N was applied. With a multiple ET system, two probes measured the displacement of five tracking points on each of the proximal and distal fragments of the tibia, thereby detecting the bending of the two fragments generated by the load. ET angle was defined as the sum of the inclinations of the proximal and distal fragments. Patients with tibial fracture treated by a cast or internal fixation were measured over time. In patients with radiographically normal healing, the bending angle decreased exponentially over time. However, in patients with nonunion, the angle remained the same over time. It was demonstrated that the ET method could be clinically applicable to evaluate fracture healing as a versatile, quantitative and noninvasive technique.