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European Journal of Trauma and Emergency Surgery

01-02-2024 | Forearm Fracture | Review Article

Diagnostic accuracy of ultrasound versus X-ray for distal forearm fractures in children and adolescents: a systematic review and meta-analysis

Authors: Ioannis Delniotis, Vangelis Bontinis, Kiriakos Ktenidis, Elena E. Drakonaki, Nikiforos Galanis

Published in: European Journal of Trauma and Emergency Surgery

Abstract

Purpose

Utilizing ultrasound for the detection of distal forearm fractures in children presents a potential safe and radiation-free alternative compared to X-ray.

Methods

A systematic review was undertaken to compare the diagnostic accuracy of ultrasound in detecting distal forearm fractures in children with X-ray imaging within the period spanning January 2010 to August 2023. The electronic databases MEDLINE and Cochrane CENTRAL were utilized for data retrieval. The QUADAS-2 tool was employed to assess the quality of the included studies. Subsequent statistical analysis was performed to calculate pooled sensitivity and specificity, positive and negative likelihood ratios, as well as the diagnostic odds ratio.

Results

Our meta-analysis included seventeen studies, encompassing a total of 2003 patients, 2546 ultrasound scans, and 1203 fracture cases as identified by the reference test (X-ray). The pooled sensitivity and specificity were 0.96 (95% CI: 0.93–0.98) and 0.96 (95% CI: 0.89–0.98), respectively. The positive likelihood ratio was 13.40 (95% CI: 7.97–21.50), the negative likelihood ratio was 0.06 (95% CI: 0.04–0.1), and the pooled diagnostic odds ratio was 209 (95% CI: 92.20–412.00). Our statistical analysis revealed low heterogeneity within our studied cohort.

Conclusions

Our study indicates that ultrasound exhibits exceptionally high accuracy in the detection of distal forearm fractures in children and adolescents. It can be employed safely to either confirm or rule out a fracture, thus circumventing the need for potentially harmful radiation exposure in this vulnerable population. Future research endeavors should focus on establishing a universally accepted protocol for training and scanning methods to standardize practices and eliminate disparities in diagnostic procedures.

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Title: Diagnostic accuracy of ultrasound versus X-ray for distal forearm fractures in children and adolescents: a systematic review and meta-analysis
Authors: Ioannis Delniotis
Vangelis Bontinis
Kiriakos Ktenidis
Elena E. Drakonaki
Nikiforos Galanis
Publication date: 01-02-2024
Publisher: Springer Berlin Heidelberg
Keyword: Forearm Fracture
Published in: European Journal of Trauma and Emergency Surgery
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-024-02451-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Diagnostic accuracy of ultrasound versus X-ray for distal forearm fractures in children and adolescents: a systematic review and meta-analysis

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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