Sonographic Diagnosis of Metaphyseal Forearm Fractures in Children

Eckert, K.; Ackermann, O.; Schweiger, Bernd; Radeloff, E.; Liedgens, P.

doi:10.1097/pec.0b013e318267a73d

Cited by 43 publications

(46 citation statements)

References 12 publications

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“…48 In addition to eight articles that had not been published at that time, 20,[26][27][28]32,33,41,46 our study includes thirteen other articles not included in that review. 21,22,24,25,29,30,[34][35][36]38,41,43,44 Additional studies were possibly found as a result of a more comprehensive search strategy. Our review reaches similar conclusions, that PoCUS is a useful tool to supplement radiographs for the detection of fractures.…”

Section: Discussionmentioning

confidence: 99%

“…All studies reported both the sensitivity and specificity of PoCUS, and LRs were calculated from these values when the authors did not include them in their manuscripts. Twenty-five studies 7,[20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][41][42][43][44] were included, ranging from 26 to 653 patients. Collectively, these studies included 2,982 patients and identified 1,200 fractures, with fracture prevalence ranging from 7% to 71% (aggregate prevalence of 40.2%).…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Collectively, these studies included 2,982 patients and identified 1,200 fractures, with fracture prevalence ranging from 7% to 71% (aggregate prevalence of 40.2%). Twelve of the 25 (48%) studies focused on one body area only, either the forearm 7,[20][21][22][23][24][25][26] or the ankle, 27-30 and 13 of 25 (52%) studies recruited exclusively pediatric patients. 7,[20][21][22][23][24][25][26]31,[36][37][38][39] Sensitivity for the detection of LBFs with PoCUS ranged from 64.7% to 100%, with 20 of 25 (80%) studies achieving rates of > 90%.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…7,[20][21][22][23][24][25]39,43,44 Forest plots of the included studies' sensitivity and specificity are shown in Figure 4. The studies' pooled test characteristics were as follows: sensitivity 93.1% (95% CI, 87.2%-96.4%), specificity 92.9% (95% CI, 86.6%-96.4%), LR(+ ) 14.1 (95% CI, 6.71-25), and LR(-) 0.08 (95% CI, 0.04-0.15).…”

Section: Meta-analysis Of Selected Studiesmentioning

confidence: 99%

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Use of point-of-care ultrasound in long bone fractures: a systematic review and meta-analysis

Chartier

Bosco

Lapointe‐Shaw

et al. 2016

CJEM

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Objectives: Long bone fractures (LBFs) are among the most frequent traumatic injuries seen in emergency departments. Reduction and immobilization is the most common form of treatment for displaced fractures. Point-of-care ultrasound (PoCUS) is a promising technique for diagnosing LBFs and assessing the success of reduction attempts. This article offers a comprehensive review of the use of PoCUS for the diagnosis and reduction of LBFs. Data source: MEDLINE and EMBASE databases were searched through July 19, 2015. Study selection: We included prospective studies that assessed test characteristics of PoCUS in 1) the diagnosis or 2) the reduction of LBFs. The methodological quality of the included studies was evaluated using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. Data extraction: Thirty studies met inclusion criteria (n = 3,506; overall fracture rate 48.0%). Test characteristics of PoCUS for the diagnosis of LBFs were as follows: sensitivity 64.7%-100%, specificity 79.2%-100%, positive likelihood ratio (LR) 3.11-infinity, and negative LR zero-0.45. Sensitivity and specificity for the adequate reduction of LBFs with PoCUS were 94%-100% and 56%-100%, respectively. PoCUS diagnosis of pediatric forearm fractures in 10 studies showed a pooled sensitivity of 93.1% (95% confidence interval [CI], 87.2%-96.4%) and specificity of 92.9% (95% CI, 86.6%-96.4%), and PoCUS diagnosis of adult ankle fractures in four studies showed a pooled sensitivity of 89.5% (95% CI, 77.0%-95.6%) and specificity of 94.2% (95% CI, 86.1%-97.7%). Conclusion: PoCUS demonstrates good diagnostic accuracy in all LBFs studied, especially in pooled results of diagnosis of pediatric forearm and adult ankle fractures. PoCUS is an appropriate adjunct to plain radiographs for LBFs. RÉSUMÉObjectifs: Les fractures des os longs (FOL) figurent parmi les blessures traumatiques les plus fréquentes au service des urgences, et les traitements les plus courants des fractures avec déplacement consistent en la réduction et l'immobilisation du membre touché. L'échographie au point de service (EPS) est une technique prometteuse dans le diagnostic des FOL et dans l'évaluation de la réussite des tentatives de réduction. Aussi les auteurs ont-ils procédé à un examen exhaustif de la documentation médicale sur l'utilisation de l'EPS dans le diagnostic et la réduction des FOL, et ils font état des résultats dans le présent article. Source de données: Des recherches ont été effectuées dans les bases de données MEDLINE et EMBASE jusqu'au 19 juillet 2015 inclusivement. Sélection des etudes: Ont été retenues des études prospectives visant à évaluer les caractéristiques de fonctionnement de l'EPS au regard 1) du diagnostic ou 2) de la réduction des FOL. La qualité méthodologique des études sélectionnées a été évaluée l'aide de l'outil Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2). Extraction des données: Trente études respectaient les critères de sélection (n = 3506; taux général de fracture : 48,0 %). Les caractéristiques de fo...

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Section: Discussionmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Meta-analysis Of Selected Studiesmentioning

confidence: 99%

See 2 more Smart Citations

Use of point-of-care ultrasound in long bone fractures: a systematic review and meta-analysis

Chartier

Bosco

Lapointe‐Shaw

et al. 2016

CJEM

View full text Add to dashboard Cite

show abstract

“…Da kindliches Knochengewebe jedoch deutlich strahlensensibler als das des Erwachsenenalters ist, sollte jede unnötige ionisierende Strahlung vermieden werden. Zahlreiche Publikationen belegen mittlerweile den sinnvollen Einsatz der Sonographie im Rahmen der primären Frakturdiagnostik, und systematische Untersuchungen mit direktem Vergleich zur Röntgendiagnostik zeigen, dass die Sonographie bei bestimmten Frakturentitäten das Röntgen ergänzen oder sogar ersetzen kann [1][2][3][4][5][6]. Bei gleicher diagnostischer Qualität kann so die Zahl unnötiger Röntgenuntersuchungen reduziert werden.…”

Section: Sonographische Frakturdiagnostikunclassified