The effectiveness of bedside point-of-care ultrasonography in the diagnosis and management of metacarpal fractures

Kozacı, Nalan; Ay, Mehmet Oğuzhan; Akçimen, Mehmet; Sasmaz, Ikbal; Turhan, Gokcen; Boz, Ali Fuat

doi:10.1016/j.ajem.2015.06.052

Cited by 32 publications

(27 citation statements)

References 22 publications

(27 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Ultrasound has already shown usefulness in the follow up of fracture healing, where callus and fracture union on ultrasound predates its appearances compared to radiographs [ 53 – 55 ]. Also, ultrasound-measured axis compared to conventional x-ray do show comparable results [ 2 , 31 , 37 , 38 , 42 , 56 ], and ultrasound is increasingly used to determine successful realignment of forearm fractures during closed reductions [ 57 – 61 ].…”

Section: Discussionmentioning

confidence: 99%

Ultrasound for Distal Forearm Fracture: A Systematic Review and Diagnostic Meta-Analysis

et al. 2016

View full text Add to dashboard Cite

Study ObjectiveTo determine the diagnostic accuracy of ultrasound for detecting distal forearm fractures.MethodsA systematic review and diagnostic meta-analysis was performed according to the PRISMA statement. We searched MEDLINE, Web of Science and the Cochrane Library from inception to September 2015. All prospective studies of the diagnostic accuracy of ultrasound versus radiography as the reference standard were included. We excluded studies with a retrospective design and those with evidence of verification bias. We assessed the methodological quality of the included studies with the QUADAS-2 tool. We performed a meta-analysis of studies evaluating ultrasound to calculate the pooled sensitivity and specificity with 95% confidence intervals (CI95%) using a bivariate model with random effects. Subgroup and sensitivity analysis were used to examine the effect of methodological differences and other study characteristics.ResultsOut of 867 publications we included 16 studies with 1,204 patients and 641 fractures. The pooled test characteristics for ultrasound were: sensitivity 97% (CI95% 93–99%), specificity 95% (CI95% 89–98%), positive likelihood ratio (LR) 20.0 (8.5–47.2) and negative LR 0.03 (0.01–0.08). The corresponding pooled diagnostic odds ratio (DOR) was 667 (142–3,133). Apparent differences were shown for method of viewing, with the 6-view method showing higher specificity, positive LR, and DOR, compared to the 4-view method.ConclusionThe present meta-analysis showed that ultrasound has a high accuracy for the diagnosis of distal forearm fractures in children when used by proper viewing method. Based on this, ultrasound should be considered a reliable alternative, which has the advantages of being radiation free.

show abstract

Section: Discussionmentioning

confidence: 99%

Ultrasound for Distal Forearm Fracture: A Systematic Review and Diagnostic Meta-Analysis

et al. 2016

View full text Add to dashboard Cite

show abstract

“…Ackermann et al (7,18) report that ultrasound can reliably be used to evaluate axis deviation in pediatric fractures of the forearm and proximal humerus; Yesilaras et al (32) report the same finding for metacarpal fractures. According to Kozaci et al, treatment decisions for forearm and metacarpal fractures made on the basis of ultrasound examinations alone match those made on the basis of x-ray images (34,35). Even ultrasound-guided reduction of displaced fractures was found to be successful in 92% of pediatric forearm fractures (15) and 91% of pediatric long-bone fractures (17).…”

Section: The Clinical Perspectivementioning

confidence: 99%

The Investigation of Suspected Fracture— a Comparison of Ultrasound With Conventional Imaging

Schmid¹,

Lippmann²,

Unverzagt³

et al. 2017

Deutsches Ärzteblatt International

View full text Add to dashboard Cite

show abstract

“…Ultrasonography (US) is currently used in ED for the management of trauma patients and in the resuscitation processes, as well as for identifying abdominal, cardiothoracic, and vascular injuries [5,6]. US is advantageous because it is easily accessible, inexpensive, reproducible, portable, free of ionizing radiation, and it provides real-time imaging.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Point-of-Care Ultrasonography and Radiography in the Diagnosis of Long-Bone Fractures

et al. 2019

Self Cite

View full text Add to dashboard Cite

Background and objectives: In this study, the accuracy of point-of-care ultrasonography (POCUS) was compared to radiography (XR) in the diagnosis of fractures, the determination of characteristics of the fractures, and treatment selection of fractures in patients admitted to the emergency department (ED) due to trauma and suspected long bone (LB) fractures. Materials and Methods: The patients were included in the study, who were admitted to ED due to trauma, and had physical examination findings suggesting the presence of fractures in LB (humerus, radius, ulna, femur, tibia, and fibula). The patients were evaluated by two emergency physicians (EP) in ED. The first EP examined LBs with POCUS and the second EP examined them with XR. LBs were evaluated on the anterior, posterior, medial, and lateral surfaces and from the proximal joint to the distal one (shoulder, elbow, wrist, hip, knee, and ankle joint) in both longitudinal and transverse axes with POCUS. Results: A total of 205 patients with suspected LB fractures were included in the study. LB fractures were determined in 99 patients with XR and in 105 patients with POCUS. The sensitivity, specificity, positive predictive value, negative predictive value of POCUS in determining the fractures were 99%, 93%, 93%, and 99%, respectively, compared to XR. Compared to XR, POCUS was able to determine 100% of fissure type fractures (kappa (κ) value: 0.765), 83% of linear fractures (κ: 0.848), 92% of fragmented fractures(κ: 0.756), 67% of spiral fractures (κ:0.798), 75% of avulsion type fractures (κ: 0.855), and 100% of full separation type fractures (κ: 0.855).Conclusions: This study has demonstrated that POCUS has a high sensitivity in diagnosing LB fractures. POCUS has a high sensitivity in identifying fracture characteristics. POCUS can be used as an alternative imaging method to XR in the diagnosis of LB fractures and in the determination of fracture characteristics.

show abstract

The effectiveness of bedside point-of-care ultrasonography in the diagnosis and management of metacarpal fractures

Cited by 32 publications

References 22 publications

Ultrasound for Distal Forearm Fracture: A Systematic Review and Diagnostic Meta-Analysis

Ultrasound for Distal Forearm Fracture: A Systematic Review and Diagnostic Meta-Analysis

The Investigation of Suspected Fracture— a Comparison of Ultrasound With Conventional Imaging

Comparison of Point-of-Care Ultrasonography and Radiography in the Diagnosis of Long-Bone Fractures

Contact Info

Product

Resources

About