genortГений ортопедииGenij Ortopedii1028-44272542-131XЦЕНТР ИЛИЗАРОВА10.18019/028-4427-2021-27-3-374-382genort-2650Research ArticleОригинальные статьиOriginal articlesМониторинговая ценность ультразвукового исследования при сращении в зоне контакта после перемещения фрагмента большеберцовой кости с помощью аккордеонного маневраThe monitoring value of ultrasonography in the treatment of bone union at the docking site after tibial bone transport by accordion maneuverHeG.HeG.

Guoyu He,

Taiyuan

Guoyu He,

Taiyuan

yhzhy@139.comZhouX.ZhouX.

Xin Zhou,

Taiyuan

Xin Zhou,

Taiyuan

yhzhy@139.comShiY.ShiY.

Ying Shi,

Taiyuan

Ying Shi,

Taiyuan

yhzhy@139.comWangD.WangD.

Dong Wang,

Taiyuan

 Dong Wang,

Taiyuan

yhzhy@139.comYuJ.YuJ.

Jing Yu,

Taiyuan

 Jing Yu,

Taiyuan

yhzhy@139.comXingH.XingH.

Hao Xing,

Taiyuan

Hao Xing,

Taiyuan

yhzhy@139.comYinH.YinH

Haiyang Yin,

Taiyuan

Haiyang Yin,

Taiyuan

yhzhy@139.comZhangJ.ZhangJ.

Jin Zhang, 

Taiyuan

Jin Zhang,

Taiyuan

yhzhy@139.comLiuH.LiuH.

Hong Liu,

Taiyuan

 Hong Liu,

Taiyuan

yhzhy@139.comWangB.WangB.

Baona Wang,

Taiyuan

Baona Wang,

Taiyuan

yhzhy@139.comJiaY.JiaY.

Yingwei Jia,

Taiyuan

Yingwei Jia,

Taiyuan

yhzhy@139.comZhangY.ZhangY.

 Yonghong Zhang,

Taiyuan

Yonghong Zhang,

Taiyuan

yhzhy@139.comThe second Hospital of Shanxi Medical UniversityКитайThe second Hospital of Shanxi Medical UniversityChina202128062021273№ 3 (2021)374382Copyright © He G., Zhou X., Shi Y., Wang D., Yu J., Xing H., Yin H., Zhang J., Liu H., Wang B., Jia Y., Zhang Y., 20212021He G., Zhou X., Shi Y., Wang D., Yu J., Xing H., Yin H., Zhang J., Liu H., Wang B., Jia Y., Zhang Y.He G., Zhou X., Shi Y., Wang D., Yu J., Xing H., Yin H., Zhang J., Liu H., Wang B., Jia Y., Zhang Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.ilizarov-journal.com/jour/article/view/2650Цель

Цель. Изучить значение ультразвука при сращении костей в зоне стыковки с помощью техники аккордеона.

Материалы и методы

Материалы и методы. Было набрано шестнадцать пациентов. Операция по типу «гармошки» была произведена в месте стыковки после транспортировки кости. Конкретными маневрами операции было сжатие, приостановка регулировки, отвлечение, втягивание. Ультразвук использовался для мониторинга гематомы, ровотока и образования костных мозолей в зоне и вокруг места стыковки на каждом этапе.

Результаты

Результаты. 1. При компрессии выявлено 14 случаев наличия гематомы и 2 случая без гематомы. 2. Размер гематомы отрицательно коррелировал со временем заживления кости в области стыковки и индексом сопротивления кровотоку. 3. Перед ретракцией кровоток по шкале Адлера постепенно увеличивался, а затем постепенно снижался. Но степень минерализации костной мозоли продолжала расти.

Заключение

Заключение. 1. С помощью ультразвука можно динамически отслеживать тенденцию изменения гематомы, кровотока и новой мозоли в зоне стыковки во время выполнения методики по типу «аккордеона», чтобы прогнозировать вариант формирования костной мозоли в месте стыковки. 2. Исследование предварительно демонстрирует, что компрессионное напряжение, применяемое в технике по типу «аккордеона», может способствовать заживлению кости в месте стыковки.

Purpose

Purpose. To explore the value of ultrasound in the treatment of bone union at the docking site by accordion technique.

Methods

Methods. Sixteen patients were recruited. The accordion operation was performed at the docking site after bone transport. The specific operation process was compression, suspension of adjustment, distraction, retraction. Ultrasound was used to monitor the hematoma, blood flow and callus in and around the docking site at each stage.

Results

Results. (1) At the compression, there were 14 cases with hematoma and 2 cases without hematoma. (2) The size of hematoma was negatively correlated with the bone healing time of the docking site and the blood flow resistance index. (3) The Adler grading of blood flow gradually increased before the retraction, and then gradually decreased. But the degree of callus mineralization continued to rise.

Conclusion

Conclusion. (1) Ultrasound can dynamically monitor the change trend of hematoma, blood flow and new callus at the docking site during accordion operation, so as to predict the tendency of bone healing at the docking site. (2) This study can preliminarily demonstrate that the compression stress applied in accordion technique can promote the bone healing at the docking site.

УЗИаккордеонный маневргематомакровотоккостная мозольultrasonographyaccordion maneuverhematomablood flowbone callusReferencesBiomechanical Stability of Juvidur and Bone Models on Osteosyntesic Materials / P. Grubor, M. Mitković, M. Grubor, M. Mitković, L. Meccariello, G. Falzarano // Acta Inform. Med. 2016. Vol. 24, No. 4. P. 261-265. DOI: 10.5455/aim.2016.24.261-265Biomechanical Stability of Juvidur and Bone Models on Osteosyntesic Materials / P. Grubor, M. Mitković, M. Grubor, M. Mitković, L. Meccariello, G. Falzarano // Acta Inform. Med. 2016. Vol. 24, No. 4. P. 261-265. DOI: 10.5455/aim.2016.24.261-265The Challenges of Monoaxial Bone Transport in Orthopedics and Traumatology / M. Bisaccia, G. Rinonapoli, L. Meccariello, A. Caraffa, B. Cukierman, J.R. Iborra // Ortop Traumatol. Rehabil. 2017. Vol. 19, No. 4. P. 373-378. DOI: 10.5604/01.3001.0010.4646The Challenges of Monoaxial Bone Transport in Orthopedics and Traumatology / M. Bisaccia, G. Rinonapoli, L. Meccariello, A. Caraffa, B. Cukierman, J.R. Iborra // Ortop Traumatol. Rehabil. 2017. Vol. 19, No. 4. P. 373-378. DOI: 10.5604/01.3001.0010.4646Ilizarov technique, satisfactory outcome with limited resources / M.S. Khan, L.M. Di Giacomo, M. Bisaccia, W. Azzam, A. Jatoi, G. Rollo, L. Meccariello // Clin. Cases Min. Bone Metab. 2018. Vol. 15, No. 2. P. 221-226.Ilizarov technique, satisfactory outcome with limited resources / M.S. Khan, L.M. Di Giacomo, M. Bisaccia, W. Azzam, A. Jatoi, G. Rollo, L. Meccariello // Clin. Cases Min. Bone Metab. 2018. Vol. 15, No. 2. P. 221-226.Treatment of Bone Defects in War Wounds: Retrospective Study / P. Grubor, S. Milicevic, M. Grubor, L. Meccariello // Med Arh. 2015. Vol. 69, No. 4. P. 260-264. DOI: 10.5455/medarh.2015.69.260-264Treatment of Bone Defects in War Wounds: Retrospective Study / P. Grubor, S. Milicevic, M. Grubor, L. Meccariello // Med Arh. 2015. Vol. 69, No. 4. P. 260-264. DOI: 10.5455/medarh.2015.69.260-264Aktuglu K., Erol K., Vahabi A. Ilizarov bone transport and treatment of critical-sized tibial bone defects: a narrative review // J. Orthop. Traumatol. 2019. Vol. 20, No. 1. P. 22. DOI: 10.1186/s10195-019-0527-1Aktuglu K., Erol K., Vahabi A. Ilizarov bone transport and treatment of critical-sized tibial bone defects: a narrative review // J. Orthop. Traumatol. 2019. Vol. 20, No. 1. P. 22. DOI: 10.1186/s10195-019-0527-1Treatment of the chronic war tibial osteomyelitis, Gustilo type IIIB and Cierny-Mader IIIB, using various methods. A retrospective study / P. Grubor, G. Falzarano, M. Grubor, A. Piscopo, R. Franzese, L. Meccariello // EMBJ EuroMediterranean Biomedical Journal. 2014. Vol. 9, No. 2. P. 7-18. DOI:10.3269/1970-5492.2014.9.2Treatment of the chronic war tibial osteomyelitis, Gustilo type IIIB and Cierny-Mader IIIB, using various methods. A retrospective study / P. Grubor, G. Falzarano, M. Grubor, A. Piscopo, R. Franzese, L. Meccariello // EMBJ EuroMediterranean Biomedical Journal. 2014. Vol. 9, No. 2. P. 7-18. DOI:10.3269/1970-5492.2014.9.2Arthroscopic debridement of docking site in Ilizarov bone transport / P.M. Robinson, M. Papanna, F. Younis, S.A. Khan // Ann. R. Coll. Surg. Engl. 2010. Vol. 92, No. 5. P. 437-438. DOI: 10.1308/003588410x12699663903719bArthroscopic debridement of docking site in Ilizarov bone transport / P.M. Robinson, M. Papanna, F. Younis, S.A. Khan // Ann. R. Coll. Surg. Engl. 2010. Vol. 92, No. 5. P. 437-438. DOI: 10.1308/003588410x12699663903719bGiotakis N., Narayan B., Nayagam S. Distraction osteogenesis and nonunion of the docking site: is there an ideal treatment option? // Injury. 2007. Vol. 38, No. Suppl 1. P. S100-S107. DOI: 10.1016/j.injury.2007.02.015Giotakis N., Narayan B., Nayagam S. Distraction osteogenesis and nonunion of the docking site: is there an ideal treatment option? // Injury. 2007. Vol. 38, No. Suppl 1. P. S100-S107. DOI: 10.1016/j.injury.2007.02.015Moghaddam M.H., Vahedi E. Effect of decortications on union rate of tibial plating // Orthopedics. 2015. Vol. 38, No. 3. P. e213-e216. DOI: 10.3928/01477447-20150305-59Moghaddam M.H., Vahedi E. Effect of decortications on union rate of tibial plating // Orthopedics. 2015. Vol. 38, No. 3. P. e213-e216. DOI: 10.3928/01477447-20150305-59Bone and Joint Trauma Study Group (GETRAUM). Treatment of nonunion in neglected long bone shaft fractures by osteoperiosteal decortication / M. Tall, D. Bonkoungou, M. Sawadogo, S.C. Da, M.F. Toe // Orthop. Traumatol. Surg. Res. 2014. Vol. 100, No. 6. P. S299-S303. DOI: 10.1016/j.otsr.2014.07.005Bone and Joint Trauma Study Group (GETRAUM). Treatment of nonunion in neglected long bone shaft fractures by osteoperiosteal decortication / M. Tall, D. Bonkoungou, M. Sawadogo, S.C. Da, M.F. Toe // Orthop. Traumatol. Surg. Res. 2014. Vol. 100, No. 6. P. S299-S303. DOI: 10.1016/j.otsr.2014.07.005Reliability, Feasibility andValue ofEcography inClinical-functionalResultsin PatientsAffected byCarpalTunnel Syndrome: isThere aCorrelation? / M. Manni, M. Bisaccia, G. Rinonapoli, A. Schiavone, L. Meccariello, S.J. Mccabe, O. Bisaccia, C.I. Vicente, A. Cappiello, A. Caraffa // Acta Inform. Med. 2017. Vol. 25, No. 1. P. 44-48. DOI: 10.5455/aim.2017.25.44-48Reliability, Feasibility andValue ofEcography inClinical-functionalResultsin PatientsAffected byCarpalTunnel Syndrome: isThere aCorrelation? / M. Manni, M. Bisaccia, G. Rinonapoli, A. Schiavone, L. Meccariello, S.J. Mccabe, O. Bisaccia, C.I. Vicente, A. Cappiello, A. Caraffa // Acta Inform. Med. 2017. Vol. 25, No. 1. P. 44-48. DOI: 10.5455/aim.2017.25.44-48Validity and Reliability of Mini-Invasive Surgery Assisted by Ultrasound in Achilles Tendon Rupture / M. Bisaccia, G. Rinonapoli, L. Meccariello, O. Bisaccia, P. Ceccarini, G. Rollo, C. Ibáñez-Vicente, J. Cervera-Irimia, F. Sánchez-Sánchez, A. Ribes-Iborra, D. Gomez-Garrido, A. Caraffa // Acta Inform. Med. 2019. Vol. 27, No. 1. P. 40-44. DOI: 10.5455/aim.2019.27.40-44Validity and Reliability of Mini-Invasive Surgery Assisted by Ultrasound in Achilles Tendon Rupture / M. Bisaccia, G. Rinonapoli, L. Meccariello, O. Bisaccia, P. Ceccarini, G. Rollo, C. Ibáñez-Vicente, J. Cervera-Irimia, F. Sánchez-Sánchez, A. Ribes-Iborra, D. Gomez-Garrido, A. Caraffa // Acta Inform. Med. 2019. Vol. 27, No. 1. P. 40-44. DOI: 10.5455/aim.2019.27.40-44Displaced patella fractures: percutaneous cerclage wiring and second arthroscopic look / M. Bisaccia,A. Caraffa, L. Meccariello, U. Ripani, O. Bisaccia, D. Gomez-Garrido, M. Carrado-Gomez, V. Pace, G. Rollo, M. Giaracuni, G. Rinonapoli // Clin. Cases Miner. Bone Metab. 2019. Vol. 16. P. 48-52.Displaced patella fractures: percutaneous cerclage wiring and second arthroscopic look / M. Bisaccia,A. Caraffa, L. Meccariello, U. Ripani, O. Bisaccia, D. Gomez-Garrido, M. Carrado-Gomez, V. Pace, G. Rollo, M. Giaracuni, G. Rinonapoli // Clin. Cases Miner. Bone Metab. 2019. Vol. 16. P. 48-52.Value of ultrasonography for observation of early healing of humeral shaft fractures / H.Q. Su, X.Q. Zhuang, Y. Bai, H.H. Ye, X.H. Huang, B.B. Lu, S.L. Lu, D.Y. Nong, W. Wang // J. Med. Ultrason. 2013. Vol. 40, No. 3. P. 231-236. DOI: 10.1007/s10396-012-0426-zValue of ultrasonography for observation of early healing of humeral shaft fractures / H.Q. Su, X.Q. Zhuang, Y. Bai, H.H. Ye, X.H. Huang, B.B. Lu, S.L. Lu, D.Y. Nong, W. Wang // J. Med. Ultrason. 2013. Vol. 40, No. 3. P. 231-236. DOI: 10.1007/s10396-012-0426-zChachan S., Tudu B., Sahu B. Ultrasound monitoring of fracture healing: is this the end of radiography in fracture follow-ups? // J. Orthop. Trauma. 2015. Vol. 29, No. 3. P. e133-e138. DOI: 10.1097/BOT.0000000000000207Chachan S., Tudu B., Sahu B. Ultrasound monitoring of fracture healing: is this the end of radiography in fracture follow-ups? // J. Orthop. Trauma. 2015. Vol. 29, No. 3. P. e133-e138. DOI: 10.1097/BOT.0000000000000207To determine the efficacy of ultrasonography in the evaluation of bone fill at the regenerate site for mandibular distraction osteogenesis over clinical and radiographic assessment. An in vivo prospective study / N. Andrade, N. Aggrawal, G. Jadhav, V. Sahu, P.C. Mathai // J. Oral Biol. Craniofac. Res. 2018. Vol. 8, No. 2. P. 89-93. DOI: 10.1016/j.jobcr.2018.04.005To determine the efficacy of ultrasonography in the evaluation of bone fill at the regenerate site for mandibular distraction osteogenesis over clinical and radiographic assessment. An in vivo prospective study / N. Andrade, N. Aggrawal, G. Jadhav, V. Sahu, P.C. Mathai // J. Oral Biol. Craniofac. Res. 2018. Vol. 8, No. 2. P. 89-93. DOI: 10.1016/j.jobcr.2018.04.005Ultrasound follow-up of callus distraction – an alternative to roentgen diagnosis? / D. Richter, M.P. Hahn, P.A. Ostermann, A. Ekkernkamp, G. Muhr // Langenbecks Arch. Chir. Suppl. Kongressbd. 1996. Vol. 113. P. 931-933.Ultrasound follow-up of callus distraction – an alternative to roentgen diagnosis? / D. Richter, M.P. Hahn, P.A. Ostermann, A. Ekkernkamp, G. Muhr // Langenbecks Arch. Chir. Suppl. Kongressbd. 1996. Vol. 113. P. 931-933.Doppler ultrasound color flow imaging in the study of breast cancer: preliminary findings / D.D. Adler, P.L. Carson, J.M. Rubin, D. Quinn-Reid // Ultrasound Med. Biol. 1990. Vol. 16, No. 6. P. 553-559. DOI: 10.1016/0301-5629(90)90020-dDoppler ultrasound color flow imaging in the study of breast cancer: preliminary findings / D.D. Adler, P.L. Carson, J.M. Rubin, D. Quinn-Reid // Ultrasound Med. Biol. 1990. Vol. 16, No. 6. P. 553-559. DOI: 10.1016/0301-5629(90)90020-dPoposka A., Atanasov N., Dzoleva-Tolevska R. Use of ultrasonography in evaluation of new bone formation in patients treated by the method of Ilizarov // Prilozi. 2012. Vol. 33, No. 1. P. 199-208.Poposka A., Atanasov N., Dzoleva-Tolevska R. Use of ultrasonography in evaluation of new bone formation in patients treated by the method of Ilizarov // Prilozi. 2012. Vol. 33, No. 1. P. 199-208.Ilizarov treatment of tibial nonunions with bone loss / D. Paley, M.A. Catagni, F. Argnani, A. Villa, G.B. Benedetti, R. Cattaneo // Clin. Orthop. Relat. Res. 1989, No. 241. P. 146-165.Ilizarov treatment of tibial nonunions with bone loss / D. Paley, M.A. Catagni, F. Argnani, A. Villa, G.B. Benedetti, R. Cattaneo // Clin. Orthop. Relat. Res. 1989, No. 241. P. 146-165.Barker K.L., Lamb S.E., Simpson A.H. Functional recovery in patients with nonunion treated with the Ilizarov technique // J. Bone Joint Surg. Br. 2004. Vol. 86, No. 1. P. 81-85.Barker K.L., Lamb S.E., Simpson A.H. Functional recovery in patients with nonunion treated with the Ilizarov technique // J. Bone Joint Surg. Br. 2004. Vol. 86, No. 1. P. 81-85.Factors in the fracture microenvironment induce primary osteoblast angiogenic cytokine production / P.J. Bouletreau, S.M. Warren, J.A. Spector, D.S. Steinbrech, B.J. Mehrara, M.T. Longaker // Plast. Reconstr. Surg. 2002. Vol. 110, No. 1. P. 139-148. DOI: 10.1097/00006534-200207000-00025Factors in the fracture microenvironment induce primary osteoblast angiogenic cytokine production / P.J. Bouletreau, S.M. Warren, J.A. Spector, D.S. Steinbrech, B.J. Mehrara, M.T. Longaker // Plast. Reconstr. Surg. 2002. Vol. 110, No. 1. P. 139-148. DOI: 10.1097/00006534-200207000-00025Autologous bone marrow grafting combined with demineralized bone matrix improves consolidation of docking site after distraction osteogenesis / I. Hatzokos, S.I. Stavridis, E. Iosifidou, D. Karataglis, A. Christodoulou // J. Bone Joint Surg. Am. 2011. Vol. 93, No. 7. P. 671-678. DOI: 10.2106/JBJS.J.00514Autologous bone marrow grafting combined with demineralized bone matrix improves consolidation of docking site after distraction osteogenesis / I. Hatzokos, S.I. Stavridis, E. Iosifidou, D. Karataglis, A. Christodoulou // J. Bone Joint Surg. Am. 2011. Vol. 93, No. 7. P. 671-678. DOI: 10.2106/JBJS.J.00514Monitoring of fracture calluses with color Doppler sonography / G. Caruso, R. Lagalla, L. Derchi, A. Iovane, A. Sanfilippo // J. Clin. Ultrasound. 2000. Vol. 28, No. 1. P. 20-27. DOI: 10.1002/(sici)1097-0096(200001)28:13.0.co;2-wMonitoring of fracture calluses with color Doppler sonography / G. Caruso, R. Lagalla, L. Derchi, A. Iovane, A. Sanfilippo // J. Clin. Ultrasound. 2000. Vol. 28, No. 1. P. 20-27. DOI: 10.1002/(sici)1097-0096(200001)28:13.0.co;2-wIlizarov G.A. The tension-stress effect on the genesis and growth of tissues. Part I. The influence of stability of fixation and soft-tissue preservation // Clin. Orthop. Relat. Res. 1989. No. 238. P. 249-281.Ilizarov G.A. The tension-stress effect on the genesis and growth of tissues. Part I. The influence of stability of fixation and soft-tissue preservation // Clin. Orthop. Relat. Res. 1989. No. 238. P. 249-281.Early stages of bone fracture healing: formation of a fibrin-collagen scaffold in the fracture hematoma / L.F. Echeverri, M.A. Herrero, J.M. Lopez, G. Oleaga // Bull. Math. Biol. 2015. Vol. 77, No. 1. P. 156-183. DOI: 10.1007/s11538-014-0055-3Early stages of bone fracture healing: formation of a fibrin-collagen scaffold in the fracture hematoma / L.F. Echeverri, M.A. Herrero, J.M. Lopez, G. Oleaga // Bull. Math. Biol. 2015. Vol. 77, No. 1. P. 156-183. DOI: 10.1007/s11538-014-0055-3Role of fracture hematoma and periosteum during fracture healing in rats: interaction of fracture hematoma and the periosteum in the initial step of the healing process / A. Ozaki, M. Tsunoda, S. Kinoshita, R. Saura // J. Orthop. Sci. 2000. Vol. 5, No. 1. P. 64-70. DOI: 10.1007/s007760050010Role of fracture hematoma and periosteum during fracture healing in rats: interaction of fracture hematoma and the periosteum in the initial step of the healing process / A. Ozaki, M. Tsunoda, S. Kinoshita, R. Saura // J. Orthop. Sci. 2000. Vol. 5, No. 1. P. 64-70. DOI: 10.1007/s007760050010Axial shortening during distraction osteogenesis leads to enhanced bone formation in a rabbit model through the HIF-1alpha/vascular endothelial growth factor system / S. Mori, M. Akagi, A. Kikuyama, Y. Yasuda, C. Hamanishi // J. Orthop. Res. 2006. Vol. 24, No. 4. P. 653-663. DOI: 10.1002/jor.20076Axial shortening during distraction osteogenesis leads to enhanced bone formation in a rabbit model through the HIF-1alpha/vascular endothelial growth factor system / S. Mori, M. Akagi, A. Kikuyama, Y. Yasuda, C. Hamanishi // J. Orthop. Res. 2006. Vol. 24, No. 4. P. 653-663. DOI: 10.1002/jor.20076The effect of altering the mechanical loading environment on the expression of bone regenerating molecules in cases of distraction osteogenesis / M.M. Alzahrani, E.A. Anam, A.M. Makhdom, I. Villemure, R.C. Hamdy // Frontiers in Endocrinology (Lausanne). 2014. Vol. 5. Art. 214. DOI: 10.3389/fendo.2014.00214The effect of altering the mechanical loading environment on the expression of bone regenerating molecules in cases of distraction osteogenesis / M.M. Alzahrani, E.A. Anam, A.M. Makhdom, I. Villemure, R.C. Hamdy // Frontiers in Endocrinology (Lausanne). 2014. Vol. 5. Art. 214. DOI: 10.3389/fendo.2014.00214

The authors declare that there are no conflicts of interest present.