SynthesisBMC musculoskeletal disorders2020
Diagnostic accuracy of history taking, physical examination and imaging for phalangeal, metacarpal and carpal fractures: a systematic review update.
Synthesis in BMC musculoskeletal disorders, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 27 citations in OpenAlex.
- The use of cone-beam computed tomography (CBCT) in radiocarpal fractures: a diagnostic test accuracy meta-analysis.Skeletal radiology · 2022Pooled it
- Radiological Diagnosis of Suspected Scaphoid Fractures in Children: A Systematic Review.Plastic surgery (Oakville, Ont.) · 2026Article
- Diagnostic Accuracy and Stability of Multimodal Large Language Models for Hand Fracture Detection: A Multi-Run Evaluation on Plain Radiographs.Diagnostics (Basel, Switzerland) · 2026Article
- Incidence of hand and wrist disorders in primary care: a retrospective cohort study.BJGP open · 2024Article
- Fracture sonography-review of literature and current recommendations.Archives of orthopaedic and trauma surgery · 2024Review
- Commercially-available AI algorithm improves radiologists' sensitivity for wrist and hand fracture detection on X-ray, compared to a CT-based ground truth.European radiology · 2024Article
- Cinematic rendering improves the AO/OTA classification of distal femur fractures compared to volume rendering: a retrospective single-center study.Frontiers in bioengineering and biotechnology · 2023Article
- [Fracture sonography of the extremities].Der Unfallchirurg · 2022Review
- Treatment of hand and finger fractures with the Stryker Hand Plating System.German medical science : GMS e-journal · 2022Article
- Effect of Joint Use of External Minifixator and Titanium Lockplate on Total Active Motion Range and Hand Function Recovery in Comminuted Metacarpal and Phalanx Fracture Patients.Journal of healthcare engineering · 2022Article
- Triquetral Fractures Overview.Current reviews in musculoskeletal medicine · 2021Review
- What is the role of ultrasonography in the early diagnosis of scaphoid fractures?European journal of radiology open · 2021Review
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe standard diagnostic work-up for hand and wrist fractures consists of history taking, physical examination and imaging if needed, but the supporting evidence for this work-up is limited. The purpose of this study was to systematically examine the diagnostic accuracy of tests for hand and wrist fractures.
methodsA systematic search for relevant studies was performed. Methodological quality was assessed and sensitivity (Se), specificity (Sp), accuracy, positive predictive value (PPV) and negative predictive value (NPV) were extracted from the eligible studies.
resultsOf the 35 eligible studies, two described the diagnostic accuracy of history taking for hand and wrist fractures. Physical examination with or without radiological examination for diagnosing scaphoid fractures (five studies) showed Se, Sp, accuracy, PPV and NPV ranging from 15 to 100%, 13-98%, 55-73%, 14-73% and 75-100%, respectively. Physical examination with radiological examination for diagnosing other carpal bone fractures (one study) showed a Se of 100%, with the exception of the triquetrum (75%). Physical examination for diagnosing phalangeal and metacarpal fractures (one study) showed Se, Sp, accuracy, PPV and NPV ranging from 26 to 55%, 13-89%, 45-76%, 41-77% and 63-75%, respectively. Imaging modalities of scaphoid fractures showed predominantly low values for PPV and the highest values for Sp and NPV (24 studies). Magnetic Resonance Imaging (MRI), Computed Tomography (CT), Ultrasonography (US) and Bone Scintigraphy (BS) were comparable in diagnostic accuracy for diagnosing a scaphoid fracture, with an accuracy ranging from 85 to 100%, 79-100%, 49-100% and 86-97%, respectively. Imaging for metacarpal and finger fractures showed Se, Sp, accuracy, PPV and NPV ranging from 73 to 100%, 78-100%, 70-100%, 79-100% and 70-100%, respectively.
conclusionsOnly two studies were found on the diagnostic accuracy of history taking for hand and wrist fractures in the current review. Physical examination was of moderate use for diagnosing a scaphoid fracture and of limited use for diagnosing phalangeal, metacarpal and remaining carpal fractures. MRI, CT and BS were found to be moderately accurate for the definitive diagnosis of clinically suspected carpal fractures.
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