Scientific article
Ultrasound-Assisted Closed Reduction of Distal Radius Fractures

https://doi.org/10.1016/j.jhsa.2014.02.031Get rights and content

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.

Section snippets

Patients

This was a prospective study of a group of patients in whom ultrasound was used to monitor the closed reduction of distal radius fractures and compared with a retrospective control group in whom fracture reduction was performed under fluoroscopic guidance or unassisted by imaging. The present study was undertaken after receiving approval from our institutional review board. Consecutive patients undergoing ultrasound-guided closed reduction of an acute displaced distal radius fracture between

Results

Prereduction characteristics are listed in Table 1. There were no significant differences between the groups in regard to age and x-ray parameters.

The accuracy of ultrasonography measurements are demonstrated in Tables 2 and 3. Table 2 presents the displacement distances of the distal radius fractures measured by radiography and ultrasonography, which were determined from the dorsal, volar, and radial views before and immediately after reduction. No significant differences were found between

Discussion

Most patients with a displaced distal radius fracture are initially managed with closed reduction under fluoroscopy or without imaging assistance in the emergency room.8, 15 Even when surgery is indicated, a closed reduction is often performed to reduce pain and swelling. However, these methods have some problems. Fluoroscopy is not immediately available in the emergency room in Japan and many other countries. The patient and physician are exposed to radiation with its use. Although

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