HORIA HARAGUS, RADU PREJBEANU, BOGDAN TIMAR, DINU VERMESAN A-MODE ULTRASOUND ANALYSIS OF POSTOPERATIVE THIGH EDEMA IN PATIENTS WITH HIP FRACTURE Postoperative edema and lean body mass may contribute to functional outcome in frailty hip fracture patients. Advances in body mass determination have produced consistent results with A-mode ultrasound. We therefore aimed to determine the utility of A-mode ultrasound in analyzing postoperative limb edema in patients receiving treatment for proximal femur fractures. 4 males and 6 females, with an average age of 74.3 years were included. 4 had fractures of the femoral neck treated by hemiarthroplasty and the rest had extracapsular fractures which were stabilized with short intramedullary nails. Measurements were done using a commercially available A-mode 2.5MHz transducer on the thighs approximately 15 cm proximal to the patella. Comparison showed significant difference between the operated and contralateral thigh circumference (P=0.001) as well as muscle layer thickness differences between femoral neck patients and those with fractures of the trochanteric region (P=0.016). There was no correlation between the A-mode ultrasound determined superficial layer difference and entire layer difference (R2=0.037; P=0.59). However, there was linear correlation between the A-mode ultrasound determined entire layer difference and limb circumference difference, (R2=0.414; P=0.044). Postoperative thigh edema is present in all surgically treated patients for proximal femur fractures. A-mode ultrasound might be a reliable tool to examine adipose and muscle layers separately in the immediate postoperative period. There may be a difference in edema distribution between femoral neck and peritrochanteric fractures but larger samples are required.
Key words: hip fracture; postoperative edema; A-mode ultrasound; arthroplasty; Gamma Nail