Advertisement

Assessment of Bone Healing Using Ultrasound

  • Hasan Al-Nashash
  • Nasser N. Qaddoumi
Chapter

Abstract

Human bone has the remarkable capacity of remodeling and self repair through a complex regenerative healing process resulting in the gradual restoration of its mechanical properties and load bearing capacity [1]. Fracture healing goes through three distinct stages: reactive phase which includes inflammatory phase and granulation tissue formation, reparation phase which includes callus formation and lamellar bone deposition, and remodeling phase in which woven bone is replaced by mature bone. Although surgical intervention and fracture immobilization facilitate healing, fracture healing is known to be a physiological process. The connective tissue membrane covering the bone determines the healing process of a fractured bone. This connective tissue is the primary source of bone cells responsible for generating new bone during growth and repair. The length of the healing process depends on the extent of the fracture. It takes up to three weeks for the majority of upper bodily fractures and it takes up to four weeks for lower body fractures.

Keywords

Reflection Coefficient Healing Process Fracture Healing Acoustic Impedance Ultrasound Wave 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgments

This project was supported by Emirates Foundation Grant Reference Number #2009/028 entitled Quantitative Assessment of Bone Fracture Healing Using Pulsed Mode Ultrasound.

References

  1. 1.
    Nordin M, Frankel VN (2001) Basic biomechanics of the musculoskeletal System. Lippincott Williams & Wilkins, BaltimoreGoogle Scholar
  2. 2.
    Webb J, Herling G, Gardner T, Kenwright J, Simpson AH (1996) Manual assessment of fracture stiffness. Injury 27(5):319–320CrossRefPubMedGoogle Scholar
  3. 3.
    Blokhuis T, De Bruine J, Bramer J, Den Boer F, Bakker F, Patka P, Haarman H, Manoliu R (2001) The reliability of pain radiography in experimental fracture healing. Skeletal Radiol 30:151–156CrossRefPubMedGoogle Scholar
  4. 4.
    Hijazy A, Al-Smoudi H, Swedan M, Al-Nashash H, Qaddoumi N, Ramesh KG (2006) Quantitative monitoring of bone healing process using ultrasound. J Franklin Inst 343:495–500CrossRefGoogle Scholar
  5. 5.
    Augat P, Merk J, Genant H, Claes L (1997) Quantitative assessment of experimental fracture repair by peripheral computed tomography. Calcif Tissue Int 60:194–199CrossRefPubMedGoogle Scholar
  6. 6.
    Den Boer F, Bramer J, ka P, Bakker F, Barentsen R, Felizer AJ, De Lange E, Haarman H (1998) Quantification of fracture healing with three-dimensional computed tomography. Arch Orthop Trauma Surg 117:345–350Google Scholar
  7. 7.
    Protopappas V, Baga D, Fotiadis D, Likas A, Papachristos A, Malizos K (2005) An ultrasound wearable system for the monitoring and acceleration of fracture healing in long bones. IEEE Trans Biomed Eng 52(9):1597–1608CrossRefPubMedGoogle Scholar
  8. 8.
    Webb A (2003) Introduction to biomedical imaging. IEEE and WileyGoogle Scholar
  9. 9.
    Collier R, Donarski R (1987) On-invasive method of measuring the resonant frequency of a human tibia in vivo. J Biomed Eng 9:321–331CrossRefPubMedGoogle Scholar
  10. 10.
    Collier R, Donarski R, Worley A, Lay A (1993) The use of externally applied mechanical vibrations to assess both fractures and hip prosthesis. In: Turner Smith AR (ed) Micromovement in orthopaedics. Oxford University Press, Oxford, pp 151–163Google Scholar
  11. 11.
    Cunningham J, Kenwright J, Kershaw CJ (1990) Biomechanical measurement of fracture healing. J Med Eng Technol 14(3):75–79CrossRefGoogle Scholar
  12. 12.
    Lowet G, Dayuan X, Van Der Perre G (1996) Study of the vibrational behavior of a healing tibia using finite element modeling. J Biomech 29(8):1003–1010CrossRefPubMedGoogle Scholar
  13. 13.
    Malizos K, Protopappas V, Fotiadis D (2006) Guided ultrasound wave propagation in intact and healing long bones. Ultrasound Med Biol 32(5):693–708CrossRefPubMedGoogle Scholar
  14. 14.
    Heckman J, Ryaby J, McCabe J, Frey JJ, Kilcoyne R (1994) Acceleration of tibial fracture healing by non-invasive, low intensity pulsed ultrasound. J Bone Joint Surg 79(7):26–34Google Scholar
  15. 15.
    Kristiansen T, Ryaby J, McCabe J, Frey JJ, Roe L (1997) Accelerated healing of distal fractures with the use of specific low intensity ultrasound. A multicenter, prospective, randomized, double blind, placebo-controlled study. J Bone Joint Surg 79(7):961–973Google Scholar
  16. 16.
    Hantes M, Mavrodontidis A, Zalavras C, Karantanas A, Karachalios t, Malizos K (2004) Low intensity transosseous ultrasound accelerates osteotomy in a sheep fracture model. J Bone Joint Surg 86(10):2275–2282Google Scholar
  17. 17.
    Lowet G, Van der Perre G (1996) Ultrasound velocity measurement in long bone: measurement method and simulation of ultrasound wave propagation. J Biomech 29(10):1255–1262CrossRefPubMedGoogle Scholar
  18. 18.
    Njeh C, Kearton J, Hans D, Boivin C (1998) The use of quantitative ultrasound to monitor fracture healing: a feasibility study using phantoms. Med Eng Phys 20:781–786CrossRefPubMedGoogle Scholar
  19. 19.
    Bin Sediq A, Al-Nashash H, Qaddoumi N (2006) Monitoring of bone fracture healing using pulsed mode ultrasound. Transactions of the Cairo international biomedical engineering conference, pp 1–5, CairoGoogle Scholar
  20. 20.
    El-Imam F, Kittaneh S, Shinawy A, Al-Nashash H, Qaddoumi N (2011) Novel measurement technique of acoustic impedance of healing bone using pulsed ultrasound. In: Proceedings of the International Conference on Advances in Biomedical Engineering, LebanonGoogle Scholar
  21. 21.
    Wells PNT (1977) Biomedical ultrasonics. Academic, New YorkGoogle Scholar
  22. 22.
    Shull PJ (2002) Non-destructive evaluation theory, techniques, and application, 1st edn. Marcel Dekker, New YorkCrossRefGoogle Scholar
  23. 23.
    Qaddoumi N, Al-Nashash H, Bin Sediq A, Al-Shamsi H, Al-Mehrizi M, Khalaf K (2011) Towards an assessment of bone fracture healing using pulsed mode ultrasound. Technology and Health Care 19:261–269CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.American University of SharjahSharjahUAE

Personalised recommendations