Abstract
Background
Distal forearm fractures are a commonly encountered injury in the emergency department
(ED), accounting for 500,000 to 1.5 million visits and 17% of ED fractures. The evaluation
and management of these fractures frequently employs x-ray studies, conscious sedation,
closed reduction, and splinting. Point-of-care ultrasound (POCUS) can offer significant
benefit in the diagnosis and management of these common injuries.
Objective of the Review
To review the clinical utility of POCUS in the diagnosis of distal forearm fractures,
as well as to demonstrate the performance of ultrasound-guided analgesia delivery
and ultrasound-guided reduction technique.
Discussion
The initial evaluation of forearm injuries frequently includes x-ray studies. However,
multiple studies have shown ultrasound to be sensitive and specific for distal radius
fractures, with the added value of detecting soft tissue injuries missed by conventional
radiography. POCUS may also facilitate analgesia through the use of ultrasound-guided
hematoma blocks, which removes the need for conscious sedation prior to manipulation.
Finally, POCUS can be used after manipulation to assess cortical realignment of the
bone fragments and spare the patient multiple reduction attempts and repeat radiographs.
Conclusion
Distal forearm fractures are common, and the emergency physician should be adept with
the evaluation and management of these injuries. POCUS can be a reliable modality
in the detection of these fractures and can be used to facilitate analgesia and augment
success of reduction attempts. These techniques may decrease length of stay, improve
patient pain, and decrease reduction attempts.
Keywords
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Article info
Publication history
Published online: September 10, 2022
Accepted:
September 4,
2022
Received in revised form:
July 29,
2022
Received:
April 25,
2022
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
