Ultrasonography of the non-traumatic lesions of the fingers. Pictorial essay

Value of Ultrasound-Guided Closed Reduction and Minimally Invasive Fixation in the Treatment of Metacarpal Fractures

OBJECTIVES

To investigate the value of ultrasound-guided closed reduction and minimally invasive fixation in the treatment of metacarpal fractures.

METHODS

Twenty-four patients with acute metacarpal fractures were randomly divided into experimental and control groups, with 12 patients in each group. Ultrasound-guided closed reduction and fixation were performed in the experimental group, whereas C-arm fluoroscopy-assisted fixation was performed in the control group. Patients in both groups were followed to compare the treatment efficacy.

RESULTS

The success rates of ultrasound-guided closed reduction of fractures were 75.00% (9 of 12) in the experimental group and 83.33% (10 of 12) in the control group, and the difference was not statistically significant (χ²  = 0.253; P = .615) between the groups. The mean numbers of C-arm fluoroscopy-assisted procedures ± SD were 1.50 ± 0.67 times in the experimental group and 2.50 ± 0.80 in the control group, and the difference was statistically significant (t = -3.317; P = .003). The mean healing times of fractures were 5.47 ± 0.67 weeks in the experimental group and 5.73 ± 0.81 weeks in the control group; the excellence rates of total active motion were 83.33% (10 of 12) in the experimental group and 91.67% (11 of 12) in the control group; the mean grip strength values were 31.78 ± 3.13 kg in the experimental group and 33.43 ± 3.30 kg in the control group. There were no significant differences in those 3 parameters between the groups (P > .05 in each comparison).

CONCLUSIONS

Ultrasound-guided closed reduction and minimally invasive fixation is an effective treatment of metacarpal fractures and can reduce exposure to x-ray radiation.

Benign soft-tissue lesions of the fingers: radiopathological correlation and clinical considerations

Soft-tissue lesions of the fingers are commonly found in daily clinical practice. A wide range of tumors and pseudotumors have been described in this location, and the majority of them are benign. Ganglion cysts are the most common entity, and the localized type of tenosynovial giant cell tumors are the most frequent solid condition. Both may be easily recognized owing to their typical clinical and radiological characteristics. However, categorization of the spectrum of soft-tissue lesions of the fingers remains limited, despite imaging development, and many patients undergo surgery before radiological or histological diagnosis. Clinical history, radiographic features, and ultrasound and magnetic resonance patterns may help in obtaining the correct diagnosis or reducing the list of differential diagnoses. Radiologists should be familiar with imaging findings so that they can determine the size, extension, and affected neighboring anatomical structures, and provide information that allows adequate presurgical counseling.