In the past, patients with fractures were typically X-rayed, realigned, and then put in a cast. However, since only the exterior of the fracture site can be assessed, many times the alignment is still off after casting, requiring multiple adjustments. The innovative ultrasound technique developed by Dr. Vu Cong Tam at Dong Nai Children’s Hospital eliminates these difficulties.
“The issue with only being able to feel the outside of the fracture and casting right away is that the bone can remain misaligned. Often, we think it’s straight, but it’s not, leading to the need to break the cast and redo it. I have seen cases where a child needed to be recast three times without success, ultimately requiring surgery. I felt very frustrated, so I was determined to come up with a different method,” Dr. Tam recounted the motivation behind his new technique.
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Ultrasound image of a fractured bone. (Photo: provided by Dr. Tam) |
According to Dr. Tam, using ultrasound allows for a clear view of the bone; if the bone is not straight, it will also appear misaligned on the ultrasound. The doctor can observe the alignment on the screen and adjust the pieces until they fit together before proceeding with the cast. This method is more effective and scientific, reducing the need for repeated casts, and importantly, it does not require the use of X-rays (which can harm reproductive functions or affect pregnant women).
Compared to the very clear images obtained from X-rays, ultrasound images are slightly more challenging to interpret. However, “I am not a specialist in ultrasound but can still see the fractures, which shows that this technique does not require advanced ultrasound skills, and my colleagues can perform it as well,” Dr. Tam expressed.
Implemented at Dong Nai Children’s Hospital since March 2004 on nearly 100 cases, the new technique has shown a success rate of 94-95%, significantly higher than traditional X-ray methods, as it allows for direct corrections. Only the first two cases required readjustment due to inexperience. Furthermore, Dr. Tam noted that using ultrasound for bone realignment has great potential for widespread application, as ultrasound machines are now common in most hospitals at the commune level and above.
This is the first study of its kind in Vietnam. Worldwide, there has only been one similar project by an Irish author, but Dr. Tam’s research is entirely independent. On the evening of January 19, his ultrasound bone realignment technique was awarded an encouragement prize at the National Technical Innovation Contest 2005.
Based on ultrasound technology, Dr. Tam is also developing a very new technique to treat cases of fractures that cannot be realigned due to high fracture sites (such as near the hip) or oblique fractures that require surgical intervention.
Previously, in such cases, patients had to undergo open surgery, such as when a fracture occurred near the hip, which required a lengthy incision of about 14 cm, exposing the ends of the bones, and then inserting a nail into the intramedullary canal. This technique resulted in significant blood loss (over 300 ml), a high risk of infection, increased costs, prolonged hospital stays, and painful recovery.
“Our new technique addresses all of these shortcomings,” Dr. Tam stated.
His technique is called minimally invasive surgery, involving only a 1 cm incision at the knee, sufficient to insert a nail. The doctor then guides the nail to the fracture site, uses ultrasound to align the bones, and secures the nail. Patients experience minimal blood loss (only 20 ml), a very short hospital stay (maximum of 7 days), and typically can be discharged after just 2 days. This technique also does not require X-rays, only a follow-up scan for verification.
Dr. Tam mentioned that while this technique is still in the experimental phase at the hospital and has only been applied to a dozen patients, experts have recognized it as “the latest technique that the world has never seen, suitable for international reporting.” He plans to submit this technique for the National Technical Innovation Contest next year.
With such groundbreaking projects, Dr. Tam is not focused on patents or financial gain. He simply hopes that many hospitals and patients will learn about and benefit from this method.
Bich Hanh
