Extremity Fracture Diagnosis Using Bedside Ultrasound in Pediatric Trauma Patients Referring to Emergency Department; A Diagnostic Study

Authors

1 Department of Emergency Medicine, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.

2 Department of Emergency Medicine, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

3 Department of Radiology, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

4 Postdoctoral research fellow, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

5 Community Medicine Department, Tehran University of Medical Sciences, Tehran, Iran.

Abstract

Background
This study performed to assess the efficacy of ultrasound in screening upper and lower extremities fractures in comparison with standard X-ray in pediatric trauma patients.
Materials and Methods
This was a prospective diagnostic study conducted at the emergency department of Imam Khomeini Complex Hospital, Tehran, Iran. All patients with the age under 18-year-old admitted with limb trauma were first evaluated by attending emergency medicine physician using ultrasound and then underwent necessary X-rays. Thereafter, the ultrasound reports were compared with X-ray reports regarding measurement of its accuracy.
Results
Forty patients with the mean age of 9.47 ± 5.26 years (minimum of 2 and a maximum of 17 years) entered the study (75% were male). The average time of performing ultrasound in pediatric population is 3.99± 0.83 minutes which is statistically significant compared to X-ray, 16.12 ± 4.15 minutes (P<0.001). The overall sensitivity, specificity and accuracy of ultrasound in detecting fractures in evaluated pediatrics were 100%, 100% and 100%, respectively. The results showed an almost perfect agreement between ultrasound and X ray for detecting upper and lower extremity fractures in pediatrics population (k=1.00).
Conclusion
It is likely that ultrasound could be an accurate and time saving substitute for X-ray in screening for limb fractures in pediatric trauma patients admitted in emergency department.

Keywords