Abstract
Background
Painful forearm injuries after a fall occur frequently in children. X-ray study is
currently the gold standard investigation. Ultrasound (US) is a potential alternative
that avoids exposure to ionizing radiation and may be less painful than x-ray study;
and familiarity and skill with US is increasing among emergency physicians.
Objectives
The primary aim of this study was to determine if a cohort of physicians with little
or no previous experience with US could, after a short training program, safely exclude
forearm fractures in children. Secondary aims were to compare any pain or discomfort
associated with clinical examination, US, and x-ray study and to determine the acceptability
of US as a diagnostic tool to parents and patients.
Methods
A prospective, nonrandomized, interventional diagnostic study was performed on children
between the ages of 0 and 16 years who had a suspected fracture of the forearm. US
scanning was performed by a group of physicians, most with little or no previous US
experience.
Results
After the brief training program, a group of pediatric emergency physicians could
diagnose forearm fractures in children with a sensitivity of 91.5% and a specificity
of 87.6%. Pain associated with US was no better or worse than pain associated with
x-ray study. Patients and parents preferred US over x-ray study as an investigation
modality for suspected forearm fractures.
Conclusion
A group of pediatric emergency physicians with limited previous experience could,
after a short training program, diagnose forearm fractures in children. Pain associated
with US was no better or worse than pain associated with x-ray study.
Keywords
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Article info
Publication history
Published online: November 01, 2016
Accepted:
October 3,
2016
Received in revised form:
September 8,
2016
Received:
July 10,
2016
Identification
Copyright
Crown Copyright © 2016 Published by Elsevier Inc. All rights reserved.
