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Why guide the fracture with ultrasound instead of sound?
Because sound fails one in ten times. In a published study, the fracture «clack» was heard in 90% of cases, while ultrasound confirmed the monocortical fracture in 100%. Relying on hearing left one in ten patients without verification.
It is the difference between assuming the fracture happened and confirming it.
That remaining 10% does not mean the fracture did not occur: it means there was no way to know without imaging.
Ultrasound also confirms the fracture is monocortical, which is what the technique aims for.
Where this answer comes from
Is "Clack" Enough? Rib Remodeling Guided by Ultrasound
Plastic and Reconstructive Surgery - Global Open · 2024 · doi:10.1097/gox.0000000000005843
Analysis of Bicorticality in a Cohort of Post-RibXcar Patients: A Clinical and Imaging Follow-up Study
Aesthetic Surgery Journal · 2026 · doi:10.1093/asj/sjag012