Accuracy of high-frequency musculoskeletal ultrasound in hand trauma: a retrospective surgical field-based validation study at a single center.

Background: This study aims to assess the diagnostic accuracy of high-frequency musculoskeletal ultrasound in hand trauma patients, with a specific focus on tendon injury, avulsion fracture, and nerve damage, compared to surgical observations. Methods: A retrospective study was carried out on 47 hand trauma patients who received high-frequency ultrasound examinations followed by surgical intervention from January 2022 to December 2024. Ultrasound assessment with the echoes, continuity, and alterations of tendons, nerves, and bone cortex, and the surgical findings were compared with the ultrasound features. The diagnostic accuracy of ultrasound was evaluated according to surgical outcomes. Results: High-frequency ultrasound exhibited excellent diagnostic accuracy for tendon ruptures, achieving 92.86% for flexor tendons and 100% for extensor tendons, as well as 100% for avulsion fractures. Nonetheless, the accuracy was lower for tendon tears and nerve injuries, with 33.33% and 40%, respectively. Adding passive motion during ultrasound examination can enhance the accuracy of diagnosing tendon injury. Conclusion: High-frequency ultrasound provided a dependable imaging technique for the diagnosis of tendon rupture and avulsion fracture in hand trauma. It may enhance clinical assessment and guide treatment selection for hand trauma patients.