Eckert Kolja, Ackermann Ole, Schweiger Bernd, Radeloff Elke, Liedgens Peter
Department of Pediatric Surgery, Elisabeth Hospital Essen, Essen, Germany.
Pediatr Emerg Care. 2012 Sep;28(9):851-4. doi: 10.1097/PEC.0b013e318267a73d.
Metaphyseal forearm fractures are very common in childhood. Radiography of the wrist is the standard diagnostic procedure. The aim of our study was to evaluate and confirm the safety and applicability of the ultrasound diagnostic procedure in comparison to x-ray diagnosis.
We investigated 76 patients aged between 1 and 14 years. After clinical assessment, patients with suspected forearm fractures first underwent ultrasound examination of the metaphyseal forearm followed by standard 2-view radiographs of the wrist. Ultrasound and radiographic findings were then compared, and sensitivity and specificity for ultrasound were calculated.
Of 76 patients, we found 42 patients with 52 metaphyseal forearm fractures by x-rays. By ultrasound, we also diagnosed 52 fractures. All patients with no fractures were correctly diagnosed as well. Referring to x-ray, we calculated for ultrasound a sensitivity of 96.1% and a specificity of 97%. Comparing axis deviation of displaced fractures, we found a mean difference of 2.1 degrees between sonographic and x-ray values.
We confirm that ultrasound is an applicable and safe alternative tool to x-rays in nondisplaced or excluded metaphyseal forearm fractures in children.
儿童尺桡骨远端干骺端骨折非常常见。腕关节X线检查是标准的诊断方法。我们研究的目的是评估并证实超声诊断方法与X线诊断相比的安全性和适用性。
我们调查了76名年龄在1至14岁之间的患者。经过临床评估后，疑似尺桡骨骨折的患者首先接受尺桡骨远端干骺端的超声检查，随后进行标准的腕关节双视图X线检查。然后比较超声和X线检查结果，并计算超声检查的敏感性和特异性。
76名患者中，通过X线检查发现42例患者存在52处尺桡骨远端干骺端骨折。通过超声检查，我们也诊断出了52处骨折。所有未骨折的患者也都被正确诊断。参照X线检查结果，我们计算出超声检查的敏感性为96.1%，特异性为97%。比较移位骨折的轴线偏差，我们发现超声检查值与X线检查值之间的平均差异为2.1度。
我们证实，对于儿童无移位或已排除的尺桡骨远端干骺端骨折，超声是一种可应用且安全的替代X线的工具。
