Abstract
Vibrational characteristics of bone are directly dependent on its physical properties. In this study, a vibrational method for bone evaluation is introduced. We propose a new type of quantitative vibro-acoustic method based on the acoustic radiation force of ultrasound for bone characterization in persons with fracture. Using this method, we excited the clavicle or ulna by an ultrasound radiation force pulse which induces vibrations in the bone, resulting in an acoustic wave that is measured by a hydrophone placed on the skin. The acoustic signals were used for wave velocity estimation based on a cross-correlation technique. To further separate different vibration characteristics, we adopted a variational mode decomposition technique to decompose the received signal into an ensemble of band-limited intrinsic mode functions, allowing analysis of the acoustic signals by their constitutive components. This prospective study included 15 patients: 12 with clavicle fractures and three with ulna fractures. Contralateral intact bones were used as controls. Statistical analysis demonstrated that fractured bones can be differentiated from intact ones with a detection probability of 80%. Additionally, we introduce a “healing factor” to quantify the bone healing progress which successfully tracked the progress of healing in 80% of the clavicle fractures in the study.
Highlights
Speed of fracture healing may vary from one individual to another and among different fracture locations based on anatomic location, fracture severity, patient physiological state, and treatment plan
We propose a quantitative ultrasound radiation force (URF) method for detecting bone fracture and monitoring bone healing in human subjects
We found that waves generated by ultrasound radiation force excitation vary in speed, depending on the healing of the broken bone to which they are applied
Summary
Speed of fracture healing may vary from one individual to another and among different fracture locations based on anatomic location, fracture severity, patient physiological state, and treatment plan. Immobilization is the choice treatment for a majority of fractures. Determining the optimum duration of immobilization is important, as prolonged cast immobilization has multiple drawbacks, including muscle atrophy, joint stiffness, and skin breakdown. Each cast change exposes the patient to the risk of cast saw burns or lacerations [1]. Excessive immobilization can delay the healing process, since bone formation needed for healing the fracture site is stimulated by mechanical stresses through mechanosensors within the osteocytes [2]. Significant debate exists amongst musculoskeletal care providers as to identifying when a fracture is healed sufficiently
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