This study aimed to evaluate the efficacy of ultrasound (US) compared to radiography in identifying bone callus formation and fracture consolidation in the hand, specifically in metacarpal and phalangeal bones.

A prospective observational study was conducted on patients with metacarpal and phalangeal fractures who were followed up at the hand surgery and microsurgery outpatient clinic of a philanthropic hospital in São Paulo, between July 2023 and April 2024. Patients were treated either conservatively or surgically with Kirschner wire fixation. Bone callus formation was assessed through serial US exams and weekly radiographs. The follow-up period concluded when evidence of fracture consolidation was observed in both imaging modalities.

A significant difference (P<0.001) was observed between the average time of appearance of the ultrasonographic callus (29.9±9.5 days) and the radiographic callus (48±14.1 days) across all analyzed variables.

The ultrasonographic callus appeared approximately 18.2 days earlier than the radiographic callus in all studied variables.

Bone healing ultrassound assessment may be a good tool for early rehabilitation.

This findings suggests that ultrasound is a viable and effective tool for the early diagnosis of bone consolidation in phalangeal and metacarpal fractures.