Evidence map›Paper›PMID 34235602›Full record

Observational studyEmergency radiology2021

Ultrasound in forearm fractures: a pragmatic study assessing the utility of Point of Care Ultrasound (PoCUS) in identifying and managing distal radius fractures.

Darryl Wood, Maruteshwar Reddy, Ignatius Postma, Paul Bromley, John Hambridge, Chandu Wickramarachchi, Ahamed Syed Hameed

Erratum issuedAbstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Emergency radiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.9field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 11 citations in OpenAlex.

  1. Review
  2. Article
  3. Review
  4. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 1 institution in 1 country.

Darryl WoodBarking, Havering and Redbridge University Hospitals Trust, Queens Hospital, Rom Valley Way, Romford, London, RM7 0AG, UK. darrylrwood@yahoo.co.uk.ORCID http://orcid.org/0000-0002-3564-5058
Maruteshwar ReddyBarking, Havering and Redbridge University Hospitals Trust, Queens Hospital, Rom Valley Way, Romford, London, RM7 0AG, UK.
Ignatius PostmaBarking, Havering and Redbridge University Hospitals Trust, Queens Hospital, Rom Valley Way, Romford, London, RM7 0AG, UK.
Paul BromleyBarking, Havering and Redbridge University Hospitals Trust, Queens Hospital, Rom Valley Way, Romford, London, RM7 0AG, UK.
John HambridgeBarking, Havering and Redbridge University Hospitals Trust, Queens Hospital, Rom Valley Way, Romford, London, RM7 0AG, UK.
Chandu WickramarachchiBarking, Havering and Redbridge University Hospitals Trust, Queens Hospital, Rom Valley Way, Romford, London, RM7 0AG, UK.
Ahamed Syed HameedBarking, Havering and Redbridge University Hospitals Trust, Queens Hospital, Rom Valley Way, Romford, London, RM7 0AG, UK.
Barking, Havering And Redbridge University Hospitals NHS Trust · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPoint of Care Ultrasound (PoCUS) is a safe, non-invasive tool for identifying distal radius fractures and can potentially be utilised to assist clinicians to reduce displaced fractures. We aim to test whether PoCUS is accurate to identify distal radius fractures and to determine how PoCUS performs as a tool to confirm a successful fracture reduction.

methodsA pragmatic prospective observational study was done in adult patients presenting with forearm injuries resulting in Colle's type distal radius fractures. Adults who presented to the emergency department (ED) with a suspected distal forearm fracture from August 2018 to July 2019 were conveniently sampled for inclusion into the study when a trained ED ultra-sonographer was available. PoCUS scans over the point of maximal tenderness were done using a high frequency linear transducer (7.5-10 mHz) prior to X-ray. Patients who required a manipulation of the fracture had a second ultrasound scan immediately after the procedure before the second X-ray was ordered. PoCUS scans were compared to X-rays for accuracy in both groups.

resultsFractures were identified in 44 out of 47 included patients using both PoCUS and X-ray modalities. This showed a sensitivity of 100% (95% CI: 90-100%) and specificity of 100% (95% CI: 31-100%). Fracture manipulation was required in 35 out of 44 patients. The sensitivity and specificity of PoCUS in determining alignment accuracy when compared to X-ray were 100% (95% CI: 83-100%) and 64% (95% CI: 32-88%) respectively. The PPV and NPV were 86% (95% CI: 66-95%) and 100% (95% CI: 56-100%) respectively. Ten out of 44 (23%) patients with distal radius fractures ultimately required an Open Reduction and Internal Fixation (ORIF).

conclusionOur study supports the use of PoCUS for identifying distal radius forearm fractures and may have some value in assisting clinicians to determine post reduction success. We still advocate using standard X-ray radiographs to confirm successful or adequate cortical alignment following a manipulation.

Indexed as

Forearm InjuriesRadius FracturesAdultEmergency Service, HospitalForearmHumansPoint-of-Care SystemsUltrasonographyDiagnosisEmergency departmentFractures and dislocationsUltrasoundXRAY

Identifiers

PMID34235602
OpenAlexW3181708778

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.