Background: Closed reduction and cast immobilization
are employed in the primary treatment of most distal radial fractures,
and conventional radiographic techniques have been essential and effective
in monitoring these reductions. Radiation-free ultrasonography,
however, can provide both real-time and dynamic multiple-plane images
with a small and simple-to-use transducer that can be operated with
only one hand. We therefore wanted to see if the real-time and dynamic
multiple-plane observation capabilities of ultrasonography would
allow an orthopaedic surgeon to perform a closed reduction without multiple
attempts, as are frequently required when only conventional radiographic
techniques are used.
Methods: Sonographically guided closed reduction
was performed in twenty-seven consecutive wrists with an acute distal
radial fracture. The efficacy of this method was evaluated and compared
with that of conventional radiographic techniques.
Results: The sonographic images delineated the fractures
as accurately as did the conventional radiographs. All parameters measured
on the sonograms and radiographs showed substantial restoration
of anatomic alignment after reduction, and all measurements were
similar on the two types of images.
Conclusions: Sonographically guided monitoring compared
well with conventional radiographic techniques during closed reduction
of extra-articular distal radial fractures. Sonography is an accurate,
simple, and radiation-free tool that provides the substantial benefits
of dynamic multiple-plane and real-time observation.