Accuracy of Ultrasonography in Confirmation of Adequate Reduction of Distal Radius Fractures
Vol. 1 No. 1 (2013),
Page pp. 7-10
Introduction: Restoration of normal anatomic alignment is a key component of the treatment of distal radius fractures (DRF). This study aimed to evaluate the accuracy of ultrasonography (US) in determining the adequacy of closed reduction in these fractures. Methods: DRF patients admitted to the emergency department of Al-Zahra Hospital, Isfahan, Iran from September 2011 to 2012, were enrolled. After closed reduction, the adequacy was investigated through both US and control plain radiography. Then, sensitivity, specificity, positive and negative predicative values of US in confirmation of closed reduction was evaluated. Also inter-rater agreement between the two diagnostic tools was analyzed by calculating Cohen’s kappa coefficient. Results: Finally, 154 patients were evaluated (females: 53.9%) with mean age of 40.03±14.7 (range: 22-73). US had sensitivity, specificity, positive and negative predictive value of 99.3% (95%CI: 96.2-99.9), 100.0% (95%CI: 62.9-100.0), 100.0% (95%CI: 97.5-100.0), and 88.9% (95%CI: 51.7-98.1) in confirmation of the adequate reduction, respectively. In addition, inter-rater reliability was 0.94 (95%CI: 0.89-0.99; p<0.0001). Conclusion: It seems that US could be considered as a highly sensitive, accurate, easy to use, noninvasive and safe tool for guidance and confirming of closed reduction in DRF.
- Radius fractures
- closed fractures
Chen L, Kim Y, Moore CL. Diagnosis and guided reduction of forearm fractures in children using bedside ultrasound. Pediatr Emerg Care. 2007;23(8):528-31.
Chinnock B, Khaletskiy A, Kuo K, Hendey GW. Ultrasound-guided reduction of distal radius fractures. J Emerg Med. 2011;40(3):308-12.
Adams BD. Effects of radial deformity on distal radioulnar joint mechanics. J Hand surg. 1993;18 (3):492-8.
Cuenca J, Martinez A, Herrera A, Domingo J. The incidence of distal forearm fractures in Zaragoza (Spain). Chirurgie de la main. 2003;22(4):211-5.
Krackhardt T, Dilger J, Flesch I, Höntzsch D, Eingartner C, Weise K. Fractures of the distal tibia treated with closed reduction and minimally invasive plating. Arch Orthop Trauma Surg. 2005;125(2):87-94.
Ackermann O, Liedgens P, Eckert K, et al. Ultrasound diagnosis of juvenile forearm fractures. J Med Ultrason. 2010;37(3):123-7.
Durston W, Swartzentruber R. Ultrasound guided reduction of pediatric forearm fractures in the ED. Am J Emerg Med. 2000;18(1):72-7.
Ang S-H, Lee S-W, Lam K-Y. Ultrasound-guided reduction of distal radius fractures. Am J Emerg Med. 2010;28(9):1002-8.
Mallmin H, Ljunghall S. Incidence of Colles' fracture in Uppsala: a prospective study of a quarter-million population. Acta Orthop. 1992;63(2):213-5.
Eckert K, Ackermann O, Schweiger B, Radeloff E, Liedgens P. Sonographic diagnosis of metaphyseal forearm fractures in children: a safe and applicable alternative to standard X-rays. Pediatr Emerg Care. 2012;28(9):851-4.
Chern T-C, Jou I-M, Lai K-A, Yang C-Y, Yeh S-H, Cheng S-C. Sonography for monitoring closed reduction of displaced extra-articular distal radial fractures. J Bone Joint Surg. 2002;84(2):194-203.
Chang H, Tay S, Chan B, Low C. Conservative treatment of redisplayed collies' fractures in elderly patients older than 60 years old-anatomical and functional outcome. Hand Surg. 2001;6(02):137-44.
Anzarut A, Johnson JA, Rowe BH, Lambert RG, Blitz S, Majumdar SR. Radiologic and patient-reported functional outcomes in an elderly cohort with conservatively treated distal radius fractures. J Hand surg. 2004;29(6):1121-7.
- Abstract Viewed: 1955 times
- PDF Downloaded: 185 times
- HTML Downloaded: 0 times