Ability of Ultrasonography in Detection of Different Extremity Bone Fractures; a Case Series Study

• Main Authors: Farzad Bozorgi, Massoud Shayesteh Azar, Seyed Hossein Montazer, Aroona Chabra, Seyed Farshad Heidari, Alireza Khalilian
• Format: Article
• Language: English
• Published: Shahid Beheshti University of Medical Sciences 2016-12-01
• Series: Emergency
• Subjects: Ultrasonography; radiography; fractures, bone; diagnosis; emergency service, hospital
• Online Access: http://journals.sbmu.ac.ir/emergency/article/view/12821

Introduction: Despite radiography being the gold standard in evaluation of orthopedic injuries, using bedside<br />ultrasonography has several potential supremacies such as avoiding exposure to ionizing radiation, availability<br />in pre-hospital settings, being extensively accessible, and ability to be used on the bedside. The aim of the<br />present study is to evaluate the diagnostic accuracy of ultrasonography in detection of extremity bone fractures.<br />Methods: This study is a case series study, which was prospectively conducted on multiple blunt trauma patients,<br />who were 18 years old or older, had stable hemodynamic, Glasgow coma scale 15, and signs or symptoms<br />of a possible extremity bone fracture. After initial assessment, ultrasonography of suspected bones was performed<br />by a trained emergency medicine resident and prevalence of true positive and false negative findings<br />were calculated compared to plain radiology. Results: 108 patients with the mean age of 44.6 § 20.4 years were<br />studied (67.6% male). Analysis was done on 158 sites of fracture, which were confirmed with plain radiography.<br />91 (57.6%) cases were suspected to have upper extremity fracture(s) and 67 (42.4%) to have lower ones.<br />The most frequent site of injuries were forearm (36.7%) in upper limbs and leg (27.8%) in lower limbs. Prevalence<br />of true positive and false negative cases for fractures detected by ultrasonography were 59 (64.8%) and 32<br />(35.52%) for upper and 49 (73.1%) and 18 (26.9%) for lower extremities, respectively. In addition, prevalence of<br />true positive and false negative detected cases for intra-articular fractures were 24 (48%) and 26 (52%), respectively.<br />Conclusion: The present study shows the moderate sensitivity (68.3%) of ultrasonography in detection<br />of different extremity bone fractures. Ultrasonography showed the best sensitivity in detection of femur (100%)<br />and humerus (76.2%) fractures, respectively. It had low sensitivity in detection of in intra-articular fractures.