Applications of Ultrasonography in Limb Lengthening and Reconstruction

Abstract

Introduction: Ultrasound technology offers multiple benefits including cost-effectiveness, portability, and lack of radiation. It allows for a wide range of diagnostic and therapeutic applications to the musculoskeletal health. We examined the utility of ultrasound in the field of limb lengthening and reconstruction (LLR), believing that this technology’s ability to improve surgical safety and improve diagnostic accuracy has a large potential to improve patient outcomes and satisfaction. Methods: A literature review was performed to determine the musculoskeletal applications of ultrasound that could be applied to LLR. In addition, four cases are presented to highlight the examples of diagnostic and therapeutic functions of ultrasonography in LLR. Results: Many widely accepted uses of ultrasonography for musculoskeletal pathologies have diagnostic and therapeutic utility in LLR. Diagnostic purposes include the evaluation of vascularity and assessment of regenerate bone quality, size, and shape. Therapeutic benefits include localization of anatomic structures, enhancing bone formation with the use of low-intensity pulsed ultrasound bone stimulation, and assisting percutaneous procedures including injections, biopsies, and drilling for nonunion/docking. Conclusions: Ultrasound can be effectively utilized for both diagnostic and therapeutic purposes in LLR. Its portability and cost-effectiveness pose a great asset to those practitioners who are trained in the techniques to utilize the technology properly. The ability to use a radiation-free modality is attractive as a means to improve the safety profile of treatment, as there is often a high radiation burden for these patients. More research is required to determine the reliability of this technology in its applications for LLR.