Accuracy of point-of-care ultrasound for identifying fractures in patients with orthopaedic trauma presenting to emergency department of the All India Institute of Medical Sciences, level 1 trauma centre

Author： Sinha Tej

Publisher： Springer Publishing Company

ISSN： 2036-3176

Source： Critical Ultrasound Journal, Vol.3, Iss.2, 2011-08, pp. : 67-70

Disclaimer: Any content in publications that violate the sovereignty, the constitution or regulations of the PRC is not accepted or approved by CNPIEC.

Previous Menu Next

Abstract

Radiography is the standard observation tool for examining orthopaedic injuries. Point-of-care ultrasonography may thus be a faster, non-invasive alternative to effectively identify bone fractures in the emergency department (ED) setting. The study compares the diagnostic utilities of BUS and radiography for identifying long bone fractures.Prospective observation study with convenience sampling was conducted in ED in patients above 5 years, with post-traumatic upper and lower limb injuries requiring standard radiological examination after informed consent. The BUS examinations were done by emergency physician (EP) who had a brief training session to detect fractures. For every subject, radiographs were taken and reviewed for the presence of fracture by blinded orthopaedic specialist. Statistical analysis was done by SPSS.One hundred and thirty-three patients were enrolled in the study. Only 42 had fracture, out of which 36 were picked up by BUS. The overall sensitivity of the BUS in detecting fracture was 85.7% with a confidence interval (CI) of 0.70-0.94 and specificity of 100% with a CI (0.95-1.00).The positive predictive value (PPV) of USG was 100% with a CI (0.86-1.00) and negative predictive value (NPV) of 93.8% with a CI (0.86-0.97). There were six additional fractures which were recognised on X-ray and were not picked up by ultrasound.Point-of-care ultrasonography can be utilised by emergency physicians after brief training to accurately identify long bone fractures. It may gain a more prominent role in pregnant and paediatric population as well as in mass casualty scenarios.