Ultrasound-assisted closed reduction of distal radius fractures

J Hand Surg Am. 2014 Jul;39(7):1287-94. doi: 10.1016/j.jhsa.2014.02.031. Epub 2014 Apr 29.

Abstract

Purpose: To assess the accuracy and ability of ultrasound for monitoring closed reduction for distal radius fractures.

Methods: Consecutive patients undergoing ultrasound-guided closed reduction of acute, displaced distal radius fractures between January 2003 and December 2006 at our department were enrolled. The control group was extracted from patients who underwent a closed reduction for similar fractures under fluoroscopy or without any imaging assistance. To confirm the accuracy of the ultrasonography measurements, displacement distance values were compared with those on radiographic imaging before and after reduction. X-ray parameters for pre- and postreduction, reduction time, total cost, and success rate were compared between the ultrasound-guided and the control groups.

Results: The ultrasound-guided group consisted of 43 patients (mean age, 68 y) and the control group consisted of 57 patients, which included 35 patients (mean age, 74 y) with fluoroscopic reduction and of 22 patients (mean age, 72 y) with reduction unaided by imaging. There were no significant displacement differences between radiographic and ultrasound measurements. In x-ray parameters for pre- and postreduction, there were no significant differences between the 2 groups. Ultrasound-guided reduction took longer than the other 2 methods. The success rate of the ultrasound and the fluoroscopic groups were similar (95% and 94%, respectively).

Conclusions: Our data suggest that ultrasound assistance can aid reduction of distal radius fractures as well as fluoroscopy.

Type of study/level of evidence: Therapeutic II.

Keywords: Ultrasound examination; closed reduction; conservative treatment; distal radius fracture.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Case-Control Studies
  • Female
  • Fluoroscopy / methods
  • Follow-Up Studies
  • Fracture Fixation / methods
  • Fracture Healing / physiology
  • Humans
  • Injury Severity Score
  • Joint Dislocations / diagnostic imaging
  • Joint Dislocations / therapy
  • Male
  • Manipulation, Orthopedic / methods*
  • Middle Aged
  • Multivariate Analysis
  • Radius Fractures / diagnostic imaging
  • Radius Fractures / therapy*
  • Range of Motion, Articular / physiology*
  • Reference Values
  • Retrospective Studies
  • Treatment Outcome
  • Ultrasonography, Interventional / methods*
  • Wrist Joint / diagnostic imaging
  • Wrist Joint / physiopathology
  • Young Adult