Ultrasound as an aid for reduction of paediatric forearm fractures

Displaced distal forearm fractures are frequently reduced in emergency departments. Not infrequently, some are not done adequately and require the tedious process of repeating the procedure, with repeated X-rays and radiation exposure, and inconvenience to patient and staff. The use of ultrasound (US) in its expanding role in the practice of emergency medicine has been proposed to visualise bone positioning.

Our department embarked on this proof of concept study to assess the usefulness of this tool.

By way of convenience sampling, we looked at whether our US interpretation correlated with the corresponding X-ray findings, pre and post manipulation of suitable fractures.

Out of 42 patients recruited over a 1-year period, we were successful in 38 (90%). Four were "unsuccessful" (10%) due to technique rather than equipment or patient factors.

Whilst before we were blind prior to a post-reduction X-ray, this "new" additional role of the ultrasound (very accessible, cost effective and safe) can now aid us in our decision making, thereby enhancing the work flow of this group of patients through the department.