Contrast-enhanced ultrasound: a viable diagnostic tool in predicting treatment failure after non-union revision surgery for upper- and lower-limb non-unions
Non-unions remain a major complication in the treatment of long-bone fractures and affect quality of life considerably. Both early detection and treatment of non-unions are essential to secure subsequent fracture union. Sufficient vascularization plays a key role in the healing process. The aim of t...
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| Main Authors: | , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
22 August 2021
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| In: |
Ultrasound in medicine & biology
Year: 2021, Volume: 47, Issue: 11, Pages: 3147-3158 |
| ISSN: | 1879-291X |
| DOI: | 10.1016/j.ultrasmedbio.2021.07.020 |
| Online Access: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.ultrasmedbio.2021.07.020 Verlag, lizenzpflichtig, Volltext: https://www.sciencedirect.com/science/article/pii/S0301562921003355 
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| Author Notes: | Julian Doll, Stefan Waizenegger, Gerhard Schmidmaier, Marc-André Weber, and Christian Fischer |
| Summary: | Non-unions remain a major complication in the treatment of long-bone fractures and affect quality of life considerably. Both early detection and treatment of non-unions are essential to secure subsequent fracture union. Sufficient vascularization plays a key role in the healing process. The aim of this prospective study was to quantify the microperfusion within non-unions by means of contrast-enhanced ultrasound (CEUS) as early as 12 wk after non-union surgery and to examine the prognostic capability of CEUS in predicting treatment failure. Among 112 patients who had undergone non-union surgery, consolidation within 36 mo was achieved in 89 patients (“responders”), whereas 23 patients showed persistent non-unions (“non-responders”) and required further surgery. CEUS quantification parameters such as peak enhancement, wash-in area under the curve and wash-in perfusion index revealed significantly higher perfusion levels in “responders” compared with “non-responders” (p < 0.05). Receiver operator characteristic curve analysis revealed that persistent fracture non-unions could be predicted with a sensitivity/specificity of 88.7%/72.2% in lower-limb non-unions and a sensitivity/specificity of 66.7%/100.0% in upper-limb non-unions. CEUS is a suitable diagnostic tool in predicting treatment failure as early as 12 wk after non-union surgery and should be integrated into the clinical routine when deciding on revision surgery at an early stage. |
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| Item Description: | Gesehen am 15.12.2021 |
| Physical Description: | Online Resource |
| ISSN: | 1879-291X |
| DOI: | 10.1016/j.ultrasmedbio.2021.07.020 |