Termičke promjene tijekom cijeljenja prijeloma distalnoga radijusa [Thermal changes during healing of distal radius fractures]

Halužan, Damir (2019) Termičke promjene tijekom cijeljenja prijeloma distalnoga radijusa [Thermal changes during healing of distal radius fractures]. PhD thesis, Sveučilište u Zagrebu.

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Abstract

Bone healing process is very complex. Increase in blood flow around the fracture during the healing process increases the temperature. Infrared thermography is a method of measuring body temperature that can detect thermal changes. A prospective study was conducted on 50 patients with the aim of investigating thermal changes during the healing of distal radius fractures and on 30 healthy volunteers for the purpose of method validation. The Flir ThermaCam B2 (Flir System Inc., Oregon, SAD) was used for all measurements. Thermographic recordings were made at one, three, five, 11 and 23 weeks after fracture. In healthy volunteers, thermographic recordings were made before plaster of Paris immobilization and 24 hours later. The contralateral hand was used for comparison. Patients' x-rays were also analyzed and fracture healing was classified by Hammer and RUSS methods. Significant temperature differences between patients with fractures and healthy volunteers at one, three, five and 11 weeks after the fracture were found, while at 23 weeks there was no temperature difference. The highest temperature differences were at the 3rd week after fracture and then the temperature difference gradually decreased. The dynamics analysis of thermal changes clearly demonstrated the influence of time on temperature changes between broken and healthy hands. Patients with repositioned fractures had a significant difference in temperature relative to those without repositioning and also a lower chance that fracture will heal in five weeks. Patients with a lower temperature difference and a lower drop in temperature had a greater chance of healing. Infrared thermography is a method that is not harmful or invasive and can be used as an additional method of fracture healing follow up in combination with x-ray and clinical examination.

Abstract in Croatian

Cijeljenje kosti je vrlo kompleksno. Prilikom cijeljenja prijeloma dolazi do povećanja protoka krvi oko mjesta prijeloma, što dovodi do porasta temperature. Infracrvena termografija metoda je mjerenja temperature tijela koja može detektirati termičke promjene. Provedeno je prospektivno istraživanje na 50 bolesnika s ciljem istraživanja termičkih promjena tijekom cijeljenja prijeloma distalnoga radijusa te na 30 zdravih dobrovoljaca sa svrhom validacije metode. Mjerenje je izvršeno pomoću Flir Thermacam B2 (Flir System Inc, Oregon, SAD). Termografska mjerenja kod bolesnika napravljena su 1., 3., 5., 11. i 23. tjedan nakon prijeloma. Kod zdravih dobrovoljaca mjerenje je napravljeno prije stavljanja sadrene imobilizacije i 24 h nakon toga. Za usporedbu je korištena suprotna ruka. Analizirane su i RTG snimke bolesnika, a tijek cijeljenja prijeloma klasificiran je metodama po Hammeru i Russu. Nađena je značajna razlika u temperaturi između bolesnika s prijelomom i zdravih dobrovoljaca u 1., 3., 5. i 11. tjednu nakon prijeloma, dok u 23. tjednu te razlike više nije bilo. Najveće razlike temperature bile su 3. tjedan poslije prijeloma, a nakon toga se razlika temperatura postepeno smanjivala. Analiza dinamike termičkih promjena jasno je pokazala utjecaj vremena na promjene temperature između slomljene i zdrave ruke. Bolesnici s repozicijom imali su značajnu razliku temperatura u odnosu na one bez repozicije, a također i manju šansu za zacjeljenje do 5. tjedna nakon prijeloma. Bolesnici s nižom razlikom i manjim padom temperature imali su veću šansu za zacjeljenje. IC termografija je metoda koja nije štetna i invazivna, a može se koristiti kao dodatna metoda kod praćenja cijeljenja prijeloma u kombinaciji s RTG-om i kliničkim pregledom.

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