Ultrasound-guided diagnosis of fractures of the distal forearm in children - 21/05/15
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Abstract |
Purpose |
Distal radius and forearm fractures are injuries that are frequently seen in trauma surgery outpatient clinics. Usually, the wrist is X-rayed in 2 planes as standard diagnostic procedure. In contrast, we evaluate in our study the accuracy of ultrasonography (US) in diagnosing these fractures.
Methods |
This prospective study includes the patients who presented at two trauma surgery clinics with a presumptive diagnosis of distal radius or forearm fracture between January and December 2012. After a clinical examination, US imaging of the distal forearm was first carried out on 6 standardized planes followed by radiographs of the wrist made in two planes. The age limit was set at the end of 11years.
Results |
In total, 201 patients between 4 and 11years of age were recruited with an average age of 9.5years at the time of the trauma. There were 104 (51.7%) fractures distributed as follows: 89 (85.9%) injuries of the distal radius, 9 (8.7%) injuries of the distal ulna, and 6 (5.8%) combined injuries (radius and ulna). Sixty-five greenstick fractures were detected. Surgery was necessary in 34 cases. Specificity and sensitivity of ultrasound diagnosis were 99.5%.
Conclusion |
Ultrasound imaging is suitable to demonstrate fractures of the distal forearm. It is a highly sensitive procedure in detecting distal forearm fractures. In our opinion, a negative result in ultrasound may reduce the need for further radiographs in children with distal forearm lesions. But in any doubtful situation the need for conventional radiographs remains.
Level of evidence |
Level III. Prospective study.
Le texte complet de cet article est disponible en PDF.Keywords : Fracture diagnosis, Ultrasonography, Childhood, Distal forearm, Pediatric fracture, Ultrasound imaging
Plan
Vol 101 - N° 4
P. 501-505 - juin 2015 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.