Does preservation of active range of motion after acute elbow injury rule out the need for the radiography?

Amiri, Hasan Ashrafian; Vahdati, Samad Shams; Fekri, Sanaz; Zadegan, Shayan Abdollah; Shokoohi, Hamid; Rahimi‐Movaghar, Vafa

doi:10.5505/tjtes.2012.26790

Cited by 3 publications

(5 citation statements)

References 16 publications

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“…Full results of the included studies are available in Supplementary Material 4 . As can be seen from Table 3 , all studies are characterized by a low risk of bias in the domains related to applicability; the study with the lowest risk of bias appears to be that by Amiri et al [ 21 ].…”

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…Among the five studies [ 13 , 14 , 21 , 22 ] included in this subgroup, very high sensitivity values emerged, reaching 100% in the studies by Darracq et al [ 13 ], Vinson et al [ 14 ]. Conversely, specificity achieved high values only in the studies of Amiri et al [ 21 ] and Darracq et al [ 13 ] (88%–97%). In Lennon et al’s study [ 23 ], diagnostic accuracy values emerged that strongly disagree with those of the rest of the studies, showing a high specificity and low sensitivity of the elbow ROM test.…”

Section: Discussionmentioning

confidence: 99%

“…Five studies [13,14,[21][22][23] (1,050 total patients) compared the elbow's range of motion (ROM) as an index test versus X-ray as a reference standard, four studies [24][25][26][27] (654 patients with fracture, 2,024 total) compared the ROM in elbow extension as an index test to X-ray as a reference standard, and three studies [28][29][30] (1,411 total patients) compared clinical clusters that included the evaluation of ROM in elbow extension and tenderness points to X-ray as a reference standard. In four studies [14,23,24,27], the values of +LR and −LR wer e also present, while, in eight studies [14,[21][22][23][24][25]27,29],VPP and VPN values were reported; in other cases, the data were extrapolated by the researchers (GDM and PC) using specific online calculators and added to the summary table of diagnostic accuracy values. Two studies [22,29] investigated this condition in children, and 10 studies investigated the same in children and in adults [13,14,21,[24][25][26]28,30].…”

Section: Article and Clinical Characteristicsmentioning

confidence: 99%

“…In four studies [14,23,24,27], the values of +LR and −LR wer e also present, while, in eight studies [14,[21][22][23][24][25]27,29],VPP and VPN values were reported; in other cases, the data were extrapolated by the researchers (GDM and PC) using specific online calculators and added to the summary table of diagnostic accuracy values. Two studies [22,29] investigated this condition in children, and 10 studies investigated the same in children and in adults [13,14,21,[24][25][26]28,30]. The total number of fractures was not calculated in relation to the global sample divided by subgroups of different index tests.…”

Section: Article and Clinical Characteristicsmentioning

confidence: 99%

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Diagnostic accuracy of clinical tests to rule out elbow fracture: a systematic review

et al. 2023

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Background: Elbow traumas represent a relatively common condition in clinical practice. However, there is a lack of evidence regarding the most accurate tests for screening these potentially serious conditions and excluding elbow fractures. The purpose of this investigation was to analyze the literature concerning the diagnostic accuracy of clinical tests for the detection or exclusion of suspected elbow fractures.Methods: A systematic review was performed using the Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy Studies (PRISMA-DTA) guidelines. Literature databases including PubMed, Cumulative Index to Nursing and Allied Health Literature, Diagnostic Test Accuracy, Cochrane, the Web of Science, and ScienceDirect were searched for diagnostic accuracy studies of subjects with suspected traumatic elbow fracture investigating clinical tests compared to imaging reference tests. The risk of bias in each study was assessed independently by two reviewers using the Quality Assessment of Diagnostic Accuracy Studies 2 checklist.Results: Twelve studies (n=4,485 patients) were included. Three different types of index tests were extracted. In adults, these tests were very sensitive, with values up to 98.6% (95% confidence interval [CI], 95.0–99.8). The specificity was very variable, ranging from 24.0% (95% CI, 19.0–30.0) to 69.4% (95% CI, 57.3–79.5). The applicability of these tests was very high, while overall studies showed a medium risk of bias.Conclusions: Elbow full rom test, elbow extension test, and elbow extension and point tenderness test appear to be useful in the presence of a negative test to exclude fracture in a majority of cases. The specificity of all tests, however, does not allow us to draw useful conclusions because there was a great variability of results obtained.

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Section: Resultsmentioning

confidence: 99%