Application value of high-frequency grayscale ultrasound for early assessment of fracture reduction after fixation of limb long bones

WU Bin; WANG Guoliang; YAN Yuxia; WANG Han; GU Fen; ZHANG Wenke; ZHANG Yunfei; LUO Wen

doi:10.13276/j.issn.2097-1656.2025.10.013

Abstract：Objective To evaluate the application value of high-frequency grayscale ultrasound in assessing the early fracture reduction following fixation of limb long bones.Methods A prospective study was conducted on patients who underwent metallic internal fixation or closed reduction for limb long bone fractures in the Department of Orthopedics,Tangdu Hospital,Air Force Medical University from October 2024 to April 2025.All patients underwent both high-frequency grayscale ultrasound and X-ray examinations within one week postoperatively.The X-ray evaluation results were taken as the gold standard to assess the image quality of high-frequency gray scale ultrasound(0=unsatisfactory,1=moderate,2=satisfactory)and its efficacy in evaluating postoperative reduction outcomes.Results In terms of evaluation of image quality of high-frequency grayscale ultrasound in 50 patients with long bone fractures,70％of the images were rated as satisfactory,22％as moderate,and 8％as unsatisfactory.Taking the assessment results of X-rays as the gold standard,the consistency of high-frequency grayscale ultrasound and X-rays in evaluating the reduction quality after fixation of limb long bone fractures(50 cases)was good(κ=0.67).The sensitivity,specificity,and accuracy of high-frequency grayscale ultrasound in evaluating anatomical reduction were 75％,100％,and 94％,respectively(P＜0.05).The consistency of high-frequency grayscale ultrasound and X-rays in evaluating the reduction quality after fixation of metaphyseal fractures(17 cases)was weak(κ=0.4).The sensitivity,specificity,and accuracy of high-frequency grayscale ultrasound in evaluating anatomical reduction were 60.0％,100.0％,and 88.2％,respectively(P＜0.05).The consistency of high-frequency grayscale ultrasound and X-rays in evaluating the reduction quality after fixation of non-metaphyseal fractures(33 cases)was high(κ=0.8).The sensitivity,specificity,and accuracy of high-frequency grayscale ultrasound in evaluating anatomical reduction were 85.7％,100.0％,and 97.0％,respectively(P＜0.05).Conclusion High-frequency gray scale ultrasound shows potential clinical value in evaluating fracture reduction quality after metallic internal fixation of limb long bones.It provides a feasible alternative for populations requiring avoidance of radiation exposure.