Abstract
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.
Keywords: hip fracture; postoperative edema; A-mode ultrasound; arthroplasty; Gamma Nail