ULTRASOUND FOR THE EARLY DIAGNOSIS OF FRACTURE-HEALING AFTER INTERLOCKING NAILING OF THE TIBIA WITHOUT REAMING

Fourteen fractures (8 open, 6 closed) were treated with small-diameter interlocking tibial nails and observed for at least 1 year. Radiograp hs were obtained to monitor the maintenance of reduction and fracture healing. The treating orthopaedic surgeon was blinded to the results o f ultrasound studies, which were obtained at 2-week intervals for 10 w eeks postoperatively and read by a radiologist who was blinded to the clinical and radiographic progress. Ultrasound correctly predicted fra cture healing in all 9 fractures that subsequently progressed to fract ure union. Of the 5 fractures that did not heal and required secondary procedures, ultrasound predicted delayed healing in 4 fractures. Over all, ultrasound was able to predict fracture healing before it was rad iographically evident. Ultrasound may provide important prognostic inf ormation concerning tibial fracture healing after treatment using inte rlocking nails without reaming. Additional study is warranted.