Fracture of the clavicle in the newborn. An ultrasound diagnosis.

Katz, Rami; Landman, Joanne; Dulitzky, F; Bar‐Ziv, Jacob

doi:10.7863/jum.1988.7.1.21

Cited by 42 publications

(14 citation statements)

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“…The value of ultrasonography as a diagnostic tool for the detection of "bone" fractures (eg, in congenital hip dislocation, fractures of the radial or clavicular bone, or fractures of the ribs or skull) has been proven in various studies. [5][6][7][8] To our knowledge, only 4 studies [9][10][11][12] have dealt with the diagnosis of nasal fractures by ultrasound imaging. Danter et al an ultrasound device to investigate nasal fractures in 18 patients.…”

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confidence: 99%

Comparison of Ultrasonography and Conventional Radiography in the Diagnosis of Nasal Fractures

Thiede

Krömer²,

Rudack³

et al. 2005

Arch Otolaryngol Head Neck Surg

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To compare the diagnostic findings of ultrasonography and radiography in nasal fractures. Design and Main Outcome Measures:In this prospective study, 63 patients (23 female and 40 male; mean age, 26.8 years) with clinical signs of a nasal bone fracture were investigated. All patients underwent radiography (lateral view of the nose plus occipitomental view) and ultrasonography (10-MHz ultrasound scanner) of the nasal dorsum and the lateral nasal walls and a clinical examination by 2 consultants. Thirty-six patients underwent nasal fracture reduction. Two radiographs and 3 ultrasound images of each patient were analyzed by 2 experienced readers at different times. After assessing the nasal dorsum and lateral nasal walls in radiographs and ultrasound images, they decided whether the nose was fractured or not or whether the results were uncertain.The results were analyzed by various statistical testing methods (for sensitivity, specificity, positive and negative predictive value, and accuracy).Results: Assessment of the lateral nasal walls revealed that ultrasonography was statistically superior (P=.04) to radiography. In contrast, assessment of the nasal dorsum showed radiography to be statistically superior (P=.01) to ultrasonography. Assessment of the nasal pyramid revealed no statistical difference between radiography and ultrasonography (P =.91). Conclusion:In assessment of the nasal pyramid, ultrasonography can be considered an alternative to radiography, with equivalent diagnostic performance.

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confidence: 99%

Comparison of Ultrasonography and Conventional Radiography in the Diagnosis of Nasal Fractures

Thiede

Krömer²,

Rudack³

et al. 2005

Arch Otolaryngol Head Neck Surg

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“…13 We have shown that ultrasound examination is an excellent method for confirming a suspected fracture of the clavicle in the neonate. One of the first studies of the use of ultrasound for the diagnosis of such fractures in the neonate was published by Katz et al, 14 but the method is still not widely used. The sonographic criteria for a clavicular fracture with interruption of the hyperechogenic zone of the bone, steps, axial deviation and visible periosteal lesions are similar to those in other fractures (Table II).…”

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confidence: 99%

Ultrasonographic imaging of fractures of the clavicle in newborn infants

Kayser

Mahlfeld

Heyde

et al. 2003

The Journal of Bone and Joint Surgery. British volume

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Fractures of the clavicle in the neonate are usually diagnosed by clinical examination and confirmed by plain radiography. Exposure of newborn infants to irradiation should be avoided if possible. Following the clinical examination of 2978 neonates, 15 had suspected fractures of the clavicle. All were confirmed by ultrasound. In combination with clinical examination, ultrasound is a satisfactory alternative to radiological assessment for the diagnosis of fractures of the clavicle in newborn children.

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“…Williamson et al [27] reported using modestly high frequency (6-10 MHz) probes to detect pediatric forearm fractures, while Chen et al reported 97% sensitivity and 100% specificity for similar pediatric fractures [25]. Finally, Katz et al [28] reported that there is no significant difference between the detection of newborn pediatric fractures with either US or radiography.…”

Section: Reported Experiencementioning

confidence: 99%

Resuscitative Long-Bone Sonography for the Clinician: Usefulness and Pitfalls of Focused Clinical Ultrasound to Detect Long-Bone Fractures During Trauma Resuscitation

Al-Kadi

Gillman

Ball

et al. 2009

Eur J Trauma Emerg Surg

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Bone has one of the highest acoustic densities (AD) in the human body. Traditionally, bone has been considered to be a hindrance to the use of ultrasound (US), as US waves are reflected by the dense matrix and obscure underlying structures. The intense wave reflection, however, can clearly illustrate the cortical bony anatomy of long bones, making cortical disruption obvious. Ultrasound can be used at the bedside concurrently with the overall trauma resuscitation, and may potentially limit the patient's and treating team's exposure to ionizing radiation, corroborate clinical findings, and augment procedural success. The extended focused assessment with sonography for trauma (EFAST) is an essential tool in the resuscitation of severe torso trauma, frequently demonstrating intra- pericardial and intra-peritoneal fluid, inferring hemo/pneumothoraces, and demonstrating cardiac function. Although it is typically considered as a diagnosis of exclusion, multiple long-bone fractures may be a source of shock and can be quickly confirmed at the bedside with EFAST. Further, the early detection of long-bone fractures can also aid in the early stabilization of severely injured patients. Sonographic evaluation for long-bone fractures may be particularly useful in austere environments where other imaging modalities are limited, such as in the battlefield, developing world, and space. While prospective study has been limited, selected series have demonstrated high accuracy among both physician and para-medical clinicians in detecting long-bone fractures. Pitfalls in this technique include reduced accuracy with the small bones of the hands and feet, as well as great reliance on user experience.

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Fracture of the clavicle in the newborn. An ultrasound diagnosis.

Cited by 42 publications

References 1 publication

Comparison of Ultrasonography and Conventional Radiography in the Diagnosis of Nasal Fractures

Comparison of Ultrasonography and Conventional Radiography in the Diagnosis of Nasal Fractures

Ultrasonographic imaging of fractures of the clavicle in newborn infants

Resuscitative Long-Bone Sonography for the Clinician: Usefulness and Pitfalls of Focused Clinical Ultrasound to Detect Long-Bone Fractures During Trauma Resuscitation

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