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[Ultrasound diagnosis of forearm fractures in children: a prospective multicenter study]
O Ackermann1, P Liedgens, K Eckert
1Klinik für Orthopädie und Unfallchirurgie, Klinikum Duisburg, Zu den Rehwiesen 9, 47055, Duisburg, Deutschland. ole.ackermann@klinikum-duisburg.de
Background:
Metaphyseal forearm fractures are a common pathology in any emergency department. The standard diagnostic procedure involves X-rays of the forearm and wrist. As former studies have shown that these fractures can be visualized using ultrasound, we compared the accuracy of sonographic and X-ray diagnostics.
Methods:
From January 2007 to May 2008, a total of 93 patients aged between 0 and 12 years with forearm trauma were initially examined using a 7.5-Mhz linear transducer. After diagnosis, axis deviation and treatment were fixed and standard X-rays were taken. The results of the two diagnostic procedures were compared. The examiners were doctors in training or consultants and underwent no specific training.
Results:
We found 77 fractures in 64 patients (50 radius, 1 ulna, 13 radius and ulna). The sensitivity of ultrasound diagnostics was 94% and the specificity 99% compared with X-ray diagnosis. Mean axis deviation differences were 1.8 degrees (radius) and 0.7 degrees (ulna).
Conclusion:
Ultrasound seems to be a valuable and safe alternative to X-ray diagnosis. Patients with inconclusive findings should undergo X-ray diagnosis.
