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. Radiographs were obtained to monitor the maintenance of reduction and fracture healing. The treating orthopaedic surgeon was blinded to the results of ultrasound studies, which were obtained at 2-week intervals for 10 weeks postoperatively and read by a radiologist who was blinded to the clinical and radiographic progress. Ultrasound correctly predicted fracture healing in all 9 fractures that subsequently progressed to fracture union. Of the 5 fractures that did not heal and required secondary procedures, ultrasound predicted delayed healing in 4 fractures. Overall, ultrasound was able to predict fracture healing before it was radiographically evident. Ultrasound may provide important prognostic information concerning tibial fracture healing after treatment using interlocking nails without reaming. Additional study is warranted.