Ultrasonography as an alternative to radiographs in assessing fracture healing

Abstract

To determine whether ultrasound can assess healing of bone and check the development of callus prior to conventional radiograph thereby enabling early diagnosis of delayed union or confirmation of union. Fracture healing was evaluated with ultrasonography and radiography on specific intervals until healing was complete; in 20 fracture sites. Based on the findings of ultrasonographic and radiographic scores were assigned to classify healing.18 out of 20 fracture sites had completely healed with mature callus formation at the end of 3 months while only 2 fracture sites showed delayed healing. In patients with normal healing, colour doppler ultrasound showed neovascularisation in the 1 month of healing. With time it was noticed that the depth and width of the fractured site was reducing and becoming more isoechoic with the adjacent normal bone sites. Assessment of these parameters being more evident on the USG were statistically significant when compared with OPG. Ultrasound can be considered as a useful guide in assessing fracture healing as a replacement to conventional imaging modalities such as the OPG, particularly in the early prediction of impaired fracture healing.