Diagnostic value of ultrasound in detecting forearm fractures in pediatric patients in the emergency department

Objective

Pediatric forearm trauma is one of the most common reasons for referral to the trauma units of emergency departments. This study investigated the diagnostic value of ultrasonography (US) in comparison with direct radiography in detecting forearm fractures in children aged 2–15 years with incomplete bone development.

Method

This prospective, observational, single-center study included patients aged 2–15 years who were conscious, had isolated forearm trauma and closed injuries, and were treated at the Emergency Medicine Clinic of Kayseri City Hospital between January 1 and August 31, 2021. Written consent was obtained from the relatives or guardians of all patients. The physician who first examined the patient filled out a research form and requested a direct radiograph. US of the soft tissue in the forearm was performed by a USG-certified investigator, who was blinded to the diagnosis and radiography results.

Results

The study examined 87 patients, including 60 males (69 %) and 27 (31 %) females. Fractures were detected in 69 (79.3 %) patients. There were 47 patients (54 %) who had only radius fractures, 20 (23 %) had radius and ulna fractures, and 2 (2.3 %) had only ulna fractures. The sensitivity of US for displaced radius fractures was 96.67 %, the selectivity was 100 %, and the total accuracy was 98.8 %. The sensitivity of US for radius fractures with no displacement was 94.59 %, the selectivity was 100 %, and the total accuracy was 97.7 %. The sensitivity of US for displaced ulna fractures was 94.1 %, the selectivity was 100 %, and the total accuracy was 98.8 %. For fractures with no ulna displacement, the sensitivity was 60 %, the specificity was 100 %, and the total accuracy was 97.7 %.

Conclusion

In this study of pediatric forearm trauma patients with suspected fractures, ultrasound had high sensitivity and specificity.