Fracture Ultrasound of the Extremities

Ackermann, O.; Simanowski, J. H.; Eckert, K.

doi:10.1055/a-1023-1782

Cited by 29 publications

(26 citation statements)

References 46 publications

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“…In the case of distal forearm fractures, the sensitivity and specificity of the exam was 94-97% and 97-99%, respectively; -Regarding the proximal humerus fractures, US was carried out in four longitudinal sections, with a specificity of 100% and a sensitivity of 94% compared with the X-ray; -Referring to the screening in case of fracture suspicion, US finds its utility especially in case of small children or in case of abuse, when it is difficult for the pediatric patients to identify the sore spot; therefore, instead of irradiating the whole limb, the US could be used for focalizing on the most probable spot of fracture [31].…”

Section: Us Compared With X-ray In the Diagnosis Of Humeral Fracturesmentioning

confidence: 99%

“…The opposite way stands ultrasonography, which is radiation-free, could be used in evolution and the child can be accompanied by a parent during the procedure, is considered a more friendly examination tool [29,30]. For these reasons, musculoskeletal ultrasound could be a valuable diagnostic tool for fractures, for evaluating the callus development, an important step that is required in follow-up treatment [31,32].…”

Section: Introductionmentioning

confidence: 99%

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Could Ultrasound Be Used as a Triage Tool in Diagnosing Fractures in Children? A Literature Review

et al. 2022

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Fracture is one of the most frequent causes of emergency department visits in children, conventional radiography being the standard imaging tool used for following procedures and treatment. This imagistic method is irradiating and harmful, especially for children due to their high cell division rate. For this reason, we searched the literature to see if musculoskeletal ultrasound is a good alternative for diagnostic and follow-up regarding fractures in the pediatric population. After searching the databases using MeSH terms and manual filters, 24 articles that compare X-ray and ultrasound regarding their specificity and sensitivity in diagnosing fractures were included in this study. In the majority of the studied articles, the specificity and sensitivity of ultrasound are around 90–100%, and with high PPVs (positive predictive values) and NPVs (negative predictive values). Although it cannot replace conventional radiography, it is a great complementary tool in fracture diagnosis, having a sensitivity of nearly 100% when combined with clinical suspicion of fracture, compared with X-ray.

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Section: Us Compared With X-ray In the Diagnosis Of Humeral Fracturesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Could Ultrasound Be Used as a Triage Tool in Diagnosing Fractures in Children? A Literature Review

et al. 2022

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“…In addition, there are other applications of bone sonography, such as osteoporosis diagnostics and for the representation of callus. In patients younger than 12, proximal humerus or clavicle fractures can be visualized by ultrasound due to the changes at the bone surface ( 103 ).…”

Section: Bone Density and Imaging - 2dmentioning

confidence: 99%

Bone Phenotyping Approaches in Human, Mice and Zebrafish – Expert Overview of the EU Cost Action GEMSTONE (“GEnomics of MusculoSkeletal traits TranslatiOnal NEtwork”)

et al. 2021

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A synoptic overview of scientific methods applied in bone and associated research fields across species has yet to be published. Experts from the EU Cost Action GEMSTONE (“GEnomics of MusculoSkeletal Traits translational Network”) Working Group 2 present an overview of the routine techniques as well as clinical and research approaches employed to characterize bone phenotypes in humans and selected animal models (mice and zebrafish) of health and disease. The goal is consolidation of knowledge and a map for future research. This expert paper provides a comprehensive overview of state-of-the-art technologies to investigate bone properties in humans and animals – including their strengths and weaknesses. New research methodologies are outlined and future strategies are discussed to combine phenotypic with rapidly developing –omics data in order to advance musculoskeletal research and move towards “personalised medicine”.

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“…Young age, stress, different developmental levels, high body mass index, casts or dressings, sedation, or anesthesia with concomitant low systemic blood pressure can hamper the neurovascular examination. Given that sonography becomes more and more decisive in diagnosing and monitoring fractures, [ 9 , 10 ] it is the purpose of this report to demonstrate the potential of DUS to identify patients with vascular compromise after SHF that is yet only reported in selected studies [ 3 , 11 , 12 ] but still far from clinical routine.…”

Section: Introductionmentioning

confidence: 99%

Duplex ultrasound for assessing vascular impairment after supracondylar humerus fractures

2022

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Background: Supracondylar humerus fractures (SHF) are the second most common fracture in children and the most common fracture in children under seven years. Subtle neurovascular lesions in displaced SHF may be underdiagnosed clinically, but their sequelae can mean life-long symptoms. Here we show that color-coded duplex ultrasound (DUS) could help to identify these patients.Methods: We reviewed records of 229 children who had recovered from SHF. Ninety patients were available for detailed questionnaires, in-depth neurovascular examinations, and DUS.Results: In 90 examined patients, only two had been known to have suffered from vascular complications before our study. Only one still complained spontaneously about perfusion-induced symptoms. Qualitative changes in blood flow in duplex-sonography were detectable in both. Another two patients showed similar changes in blood flow at the fracture site. Both reported load-induced pain and paresthesia on detailed inquisition when no vascular impairments had been known before. Thus, duplex-sonography identified two patients with vascular affections that had not been noticed before in routine clinical examinations.Conclusion: DUS can be a sensitive tool in diagnosing vascular impairments in patients with SHF. It could reduce diagnostic insecurity, especially in anesthetized or otherwise hard to examine children, and thus help avoid the therapeutic delay that otherwise might foster life-long sequelae for the patients. More studies are needed to establish age-adjusted reference values for duplexsonography of children's arms. Level of Evidence: Level III, Study of nonconsecutive patients (without consistently applied reference).Abbreviations: AO = Arbeitsgemeinschaft Osteosynthese, DUS = color-coded duplex ultrasound, ED = end-diastolic flow, SHF = supracondylar humerus fractures, SS = systolic peak flow.

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Fracture Ultrasound of the Extremities

Cited by 29 publications

References 46 publications

Could Ultrasound Be Used as a Triage Tool in Diagnosing Fractures in Children? A Literature Review

Could Ultrasound Be Used as a Triage Tool in Diagnosing Fractures in Children? A Literature Review

Bone Phenotyping Approaches in Human, Mice and Zebrafish – Expert Overview of the EU Cost Action GEMSTONE (“GEnomics of MusculoSkeletal traits TranslatiOnal NEtwork”)

Duplex ultrasound for assessing vascular impairment after supracondylar humerus fractures

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