Value of the ultrasonography in guiding closed reduction and intramedullary nail fixation for femoral shaft fractures

Abstract

Objective To study the ultrasonic image characteristics of the displaced femoral shaft fracture before and post reduction, and to explore its clinical significance in guiding the closed reduction and intramedullary nail fixation. Methods Ultrasonic imaging features of 21 cases of femoral shaft fractures were observed.Closed reduction was completed under ultrasound monitoring, and the characteristics of ultrasonic imaging after fracture reduction were observed. Fixation of femoral fractures with intramedullary nails after closed reduction was completed. Results On the long axis of the femoral shaft, the ultrasonograms displayed a gap between two hyperechoic bands(step sign). On the cross section, two short arc hyperechoic bands can be seen(double short arc sign). After the completion of closed reduction, the step sign and double short arc sign disappeared. In the front and rear of the femoral shaft, there were 2 echo lines connected to a straight line. The line in front of the femoral parallel to the rear(continuous parallel sign). Continuous parallel sign indicated that reduction was achieved, the intramedullary nail guide pin could be successfully inserted into the femoral shaft, to complete the intramedullary nail fixation. Conclusions Ultrasound imaging shows step sign and double short arc syndrome when femoral shaft fracture displaced. Post fracture reduction, the imaging shows continuous parallel sign. Observing ultrasonic image characteristics of the displaced femoral shaft fracture is effective in assisting closed reduction and intramedullary nailing for femoral shaft fractures. Key words: Ultrasonography; Femoral fractures; Reduction; Fracture fixation, internal