Formation of a periosteal regenerate after a shaft fracture according to the comparative data of ultrasonography and radiography
V.O. Lytvyshko Lytvyshko, O.K. Popsuishapka
Aim of the work — to study the shape and echogenic state of tissues in the bone fracture zone after a shaft fracture by ultrasonography and follow its relationships with the newly formed bone regenerate on X-rays. Materials and methods. Ultrasonographic examination was performed in 25 patients with shaft fracture of the humerus (13), crus (4), hip (8) on days 2–21 after the trauma using Toshiba Aplio-500 sonograph with linear detector of 5–12 Hz. Results.The main phenomenon, which was detected, was the presence of an anechogenic fusiform zone near broken bone fragments. It was visualized in the majority of examined patients, and we called it the fibrin-blood clot zone. A comparison of the size and shape of the fibrin-blood clot zone with the corresponding parameters of the newly formed periosteal bone regenerate was performed in 8 patients with humerus fracture. Ultrasonography in video recording mode allowed us to obtain information on the volumetric deformation of the fibrin-blood clot associated with the displacement of bone fragments in the process of functional loads. For example, in case of isometric tensions of the shoulder muscles, dislocations of broken bone fragments occurred, which were simultaneously accompanied by the change in the shape of the external contour of the fibrin-blood clot. Conclusions. Ultrasonography allows to evaluate the shape and size of the hematoma or fibrin-blood clot, which is in the state of forming, in the bone fracture zone, as well as to establish the character of its deformation in real time with loading. As a rule, the external contour of a fibrin-blood clot has an arch-like shape, which separates it from surrounding periosteum and muscles. A fact was confirmed that a hematoma and a fibrin-blood clot had an anechogenic structure during the first week after trauma, while echogenic inclusions appeared after the indicated time and more often in the peripheral zone. The shape and size of a fibrin-blood clot are close to the corresponding parameters of a periosteal bone regenerate. It gives ground to think that fibrin is a specific environment, on which a new bone is formed.
diaphyseal fracture; bone regenerate; fibrin-blood clot; ultrasonography
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