Ackermann O, Liedgens P, Eckert K, Chelangattucherry E, Husain B, Ruchholtz S
Klinik für Orthopädie und Unfallchirurgie, Klinikum Duisburg, Zu den Rehwiesen 9, 47055, Duisburg, Deutschland.
Unfallchirurg. 2009 Aug;112(8):706-11. doi: 10.1007/s00113-009-1586-1.
Metaphyseal forearm fractures are a common pathology in any emergency department. The standard diagnostic procedure involves X-rays of the forearm and wrist. As former studies have shown that these fractures can be visualized using ultrasound, we compared the accuracy of sonographic and X-ray diagnostics.
From January 2007 to May 2008, a total of 93 patients aged between 0 and 12 years with forearm trauma were initially examined using a 7.5-Mhz linear transducer. After diagnosis, axis deviation and treatment were fixed and standard X-rays were taken. The results of the two diagnostic procedures were compared. The examiners were doctors in training or consultants and underwent no specific training.
We found 77 fractures in 64 patients (50 radius, 1 ulna, 13 radius and ulna). The sensitivity of ultrasound diagnostics was 94% and the specificity 99% compared with X-ray diagnosis. Mean axis deviation differences were 1.8 degrees (radius) and 0.7 degrees (ulna).
Ultrasound seems to be a valuable and safe alternative to X-ray diagnosis. Patients with inconclusive findings should undergo X-ray diagnosis.
干骺端前臂骨折是任何急诊科常见的病症。标准诊断程序包括前臂和腕部的X线检查。由于既往研究表明这些骨折可用超声显示,我们比较了超声诊断和X线诊断的准确性。
2007年1月至2008年5月,共93例0至12岁前臂外伤患者最初使用7.5兆赫线性探头进行检查。诊断后,确定轴线偏差并进行治疗,然后拍摄标准X线片。比较两种诊断程序的结果。检查者为实习医生或会诊医生,未接受过专门培训。
我们在64例患者中发现77处骨折(50处桡骨、1处尺骨、13处桡骨和尺骨)。与X线诊断相比,超声诊断的敏感性为94% , 特异性为99%。平均轴线偏差差异为1.8度(桡骨)和0.7度(尺骨)。
超声似乎是X线诊断的一种有价值且安全的替代方法。检查结果不明确的患者应接受X线诊断。