Intraoperative ultrasound-guided reduction of femoral shaft fractures using intramedullary nailing: a technical note

Zhao, Zhe; Zhu, Jianjin; Song, Fei; He, Dawei; Deng, Jianzhong; Chen, Fang; Pan, Yuanjiang

doi:10.1007/s00402-018-3085-8

Cited by 5 publications

(1 citation statement)

References 23 publications

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“…Sonographic assistance is increasingly used in orthopedic surgery [14][15][16]. Thus, static, comparative, and dynamic information can now be obtained in many conditions.…”

Section: Discussionmentioning

confidence: 99%

Intraoperative checking of the first ray rotation and sesamoid position through sonographic assistance

Tejero

González-Martín

Martínez-Franco

et al. 2022

Arch Orthop Trauma Surg

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Introduction Hallux valgus (HV) deformity affects the orientation of the metatarsophalangeal (MTP) joint in three planes. Displacement in the coronal plane results in axial rotation of the first metatarsal, with progressive subluxation of the first MTP joint. Multiple techniques have been described to correct the malrotation itself. However, none of them have checked intraoperatively the final position of the first metatarsal head and sesamoids previous to the fixation of the Lapidus procedure or first metatarsal bone osteotomies. The aim of this article is to describe a novel technique to check the first ray rotation and sesamoids position through sonographic assistance. Materials and methods Before fixation of the Lapidus procedure, with the ankle in maximal dorsiflexion, the surgeon takes the linear ultrasound probe and places it on the sole to visualize the sesamoids, which should be viewed at the same level, with the flexor hallucis longus (FHL) centered between both. Once the ideal position of the head of the first ray has been achieved, temporary fixation with K-wires is performed over the first TMT joint and M1–M2 joint for further sonographic verification of the sesamoids beneath the first metatarsal head. The height of the sesamoids relative to the second metatarsal head should be checked by sonographic control too. Results Four patients were included. Three females and one male. Their mean age was 76.4 years (R 61–72). Their mean BMI was 29 (R 27.5–32.24). The mean IMA (intermetatarsal angle) was 18.2 (R 17.2–19) degrees and the mean MPA (metatarsophalangeal angle) was 50 (R 36–63) degrees. Conclusions Sonographic assistance, is a widely available, inexpensive, and comparative imaging technique that can guide the first ray rotation and sesamoids position in HV surgery, theoretically improving radiological outcomes.

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“…Sonographic assistance is increasingly used in orthopedic surgery [14][15][16]. Thus, static, comparative, and dynamic information can now be obtained in many conditions.…”

Section: Discussionmentioning

confidence: 99%

Intraoperative checking of the first ray rotation and sesamoid position through sonographic assistance

Tejero

González-Martín

Martínez-Franco

et al. 2022

Arch Orthop Trauma Surg

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Annotation-guided encoder-decoder network for bone extraction in ultrasound-assisted orthopedic surgery

Chen

Xie

et al. 2022

Computers in Biology and Medicine

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Ultrasound-guided techniques for managing length- unstable femoral shaft fractures in children

Wu,

Shen,

Wang

et al. 2024

BMC Musculoskelet Disord

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Objective The management of length-unstable femoral shaft fractures(LUFSFs) in pediatric patients is still controversial. This study aims to explore the clinical efficacy of ultrasound-guided closed reduction combined with external fixation for treating LUFSFs in children. Methods We conducted a retrospective analysis of clinical data from 19 pediatric patients with LUFSFs who underwent ultrasound-guided closed reduction and external fixation between January 2018 and January 2023. Ultrasound was employed not only to facilitate closed reduction of the fracture but also to guide real-time insertion of Schanz pins and monitor pin length as it traversed the opposite cortex. Surgical time, intraoperative fluoroscopy count, hospital stay length, fracture fixation duration, complication incidence, fracture reduction quality at the final follow-up were recorded. Results The patients’ average age was 7.5 years( range: 5 to 11 years). The mean surgical duration was 70.4 min (range: 48–105 min), and the average intraoperative fluoroscopy count was 6.5 (range: 2–16). Fracture fixation lasted an average of 10.9 weeks (range: 7–20 weeks). All patients were followed up for more than one year. 6 cases of superficial pin tract infection occurred, which resolved with oral antibiotics and enhanced needle tract care. No deep infections were observed. Temporary stiffness of the knee joint was observed in 2 patients. According to Flynn’s efficacy evaluation system, fracture reduction quality at the final follow-up was rated as excellent in 11 cases and satisfactory in 8 cases, yielding a combined success rate of 100% (19/19). Conclusions The technique of ultrasound-guided closed reduction combined with external fixation offers favorable outcomes for children aged 5 to 11 years with LUFSFs, reducing reliance on fluoroscopic guidance.

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Intraoperative ultrasound-guided reduction of femoral shaft fractures using intramedullary nailing: a technical note

Cited by 5 publications

References 23 publications

Intraoperative checking of the first ray rotation and sesamoid position through sonographic assistance

Intraoperative checking of the first ray rotation and sesamoid position through sonographic assistance

Annotation-guided encoder-decoder network for bone extraction in ultrasound-assisted orthopedic surgery

Ultrasound-guided techniques for managing length- unstable femoral shaft fractures in children

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