Ultrasound has many applications in hand and plastic surgery. It can be used to visualize osteosynthesis material, evaluate tendon injuries like ruptures or adhesions, detect lesions of the A4 pulley, diagnose tenosynovitis, locate ganglion cysts, find foreign bodies, identify tumors, assess carpal tunnel syndrome, and assist with flap surgery. Ultrasound provides diagnostic information in a non-invasive manner using modes like B-mode, Doppler, and power Doppler to examine the anatomy of the hand and wrist.

1. Échographie en chirurgie de
la main et chirurgie plastique
Dr. med. Camillo Theo Müller
Centre de la Main
Service de chirurgie plastique et de la main
CHUV

2. ULTRASOUND
• WHY ?
• HOW ?
• WHAT ?
• INDICATIONS?

3. ULTRASOUND – WHY ?
- Many applications
- TITLE SGUM <-> SCM
- US MAIN CHUV (depuis 1.12.2016)

4. ULTRASOUND – HOW ? I
- HISTORY
Lazzaro Spallanzani 1794 (BATS) (>20kHz)
Jean-Daniel Colladon 1826 (LAKE OF GENEVA)
Pierre Curie 1880 (PIEZZO)
DUSSIK 1958 (Joint)
Daniel G. McDonald 1972 (Baker’s cyst vs Thrombophlebite)
New Man 1981 (Septic Arthritis)
http://www.sonoguide.com/physics.html
https://www.bmus.org/about-ultrasound/history-of-ultrasound/

5. ULTRASOUND – HOW ? II
TEST

6. ULTRASOUND – WHAT ?
- Mode –B
- Doppler
- Power Doppler
- Mobilité

7. ULTRASOUND – WHAT ?
- WRIST (PALMAR)
- WRIST (DORSAL)
- FINGER (PALMAR)
- THUMB (MCP)

8. ULTRASOUND – INDICATION I

9. ULTRASOUND – INDICATION II

10. ULTRASOUND – INDICATION III

11. ULTRASOUND – INDICATION IV

12. ULTRASOUND – INDICATION V.1

13. ULTRASOUND – INDICATION V.2

14. ULTRASOUND – INDICATION VI

15. ULTRASOUND – INDICATION VII

16. ULTRASOUND – INDICATION VIII

17. ULTRASOUND – INDICATION IX
Diagnostic value of sonography in patients with suspected carpal tunnel syndrome: a prospective study.
Ziswiler HR, Reichenbach S, Vögelin E, Bachmann LM, Villiger PM, Jüni P. // Arthritis Rheum. 2005 Jan;52(1):304-11.

18. ULTRASOUND
Ultrasound in Neurology.
Tsivgoulis G, Alexandrov AV.
Continuum (Minneap Minn). 2016 Oct;22(5, Neuroimaging):1655-1677.
PMID: 277409993

19. ULTRASOUND – INDICATION IX

20. ULTRASOUND – INDICATION!
1. Osteosynthesis material
2. Skiers thumb
3. Tendons: rupture vs. adhesions
4. Lesion of A4
5. Tenosynovitis
6. Ganglion cyst
7. Foreign Body Localisation
8. Tumor
9. Carpal tunnel syndrome
10. Flap surgery