Related Experiment Video
Updated: Jul 18, 2026
A Simple Non-invasive Method for Temporary Knockdown of Upper Limb Proprioception
Published on: March 3, 2018
Is there sufficient evidence for tuning fork tests in diagnosing fractures? A systematic review
Kayalvili Mugunthan1, Jenny Doust1, Bodo Kurz2
1Centre for Research in Evidence Based Practice, Faculty of Health Sciences & Medicine, Bond University, Robina, Australia.
Objective:
To determine the diagnostic accuracy of tuning fork tests for detecting fractures.
Design:
Systematic review of primary studies evaluating the diagnostic accuracy of tuning fork tests for the presence of fracture.
Data Source:
We searched MEDLINE, CINAHL, AMED, EMBASE, Sports Discus, CAB Abstracts and Web of Science from commencement to November 2012. We manually searched the reference lists of any review papers and any identified relevant studies.
Study Selection And Data Extraction:
Two reviewers independently reviewed the list of potentially eligible studies and rated the studies for quality using the QUADAS-2 tool. Data were extracted to form 2×2 contingency tables. The primary outcome measure was the accuracy of the test as measured by its sensitivity and specificity with 95% CIs.
Data Synthesis:
We included six studies (329 patients), with two types of tuning fork tests (pain induction and loss of sound transmission). The studies included patients with an age range 7-60 years. The prevalence of fracture ranged from 10% to 80%. The sensitivity of the tuning fork tests was high, ranging from 75% to 100%. The specificity of the tests was highly heterogeneous, ranging from 18% to 95%.
Conclusions:
Based on the studies in this review, tuning fork tests have some value in ruling out fractures, but are not sufficiently reliable or accurate for widespread clinical use. The small sample size of the studies and the observed heterogeneity make generalisable conclusion difficult.
