Skip to main content
Top
Published in: International Journal of Emergency Medicine 4/2008

Open Access 01-12-2008 | Brief Research Report

Ultrasound as an aid for reduction of paediatric forearm fractures

Authors: Christopher Ern-Yoong Wong, Angelina Su-Yin Ang, Kee-Chong Ng

Published in: International Journal of Emergency Medicine | Issue 4/2008

Login to get access

Abstract

Background

Displaced distal forearm fractures are frequently reduced in emergency departments. Not infrequently, some are not done adequately and require the tedious process of repeating the procedure, with repeated X-rays and radiation exposure, and inconvenience to patient and staff. The use of ultrasound (US) in its expanding role in the practice of emergency medicine has been proposed to visualise bone positioning.

Aim

Our department embarked on this proof of concept study to assess the usefulness of this tool.

Method

By way of convenience sampling, we looked at whether our US interpretation correlated with the corresponding X-ray findings, pre and post manipulation of suitable fractures.

Results

Out of 42 patients recruited over a 1-year period, we were successful in 38 (90%). Four were “unsuccessful” (10%) due to technique rather than equipment or patient factors.

Conclusion

Whilst before we were blind prior to a post-reduction X-ray, this “new” additional role of the ultrasound (very accessible, cost effective and safe) can now aid us in our decision making, thereby enhancing the work flow of this group of patients through the department.
Literature
1.
go back to reference Jones K, Weiner DS (1999) The management of forearm fractures in children: a plea for conservatism. J Pediatr Orthop 19:811–815PubMed Jones K, Weiner DS (1999) The management of forearm fractures in children: a plea for conservatism. J Pediatr Orthop 19:811–815PubMed
2.
go back to reference Ng KC, Ang SY (2002) Sedation with ketamine for paediatric procedures in the emergency department: a review of 500 cases. Singapore Med J 43:300–304PubMed Ng KC, Ang SY (2002) Sedation with ketamine for paediatric procedures in the emergency department: a review of 500 cases. Singapore Med J 43:300–304PubMed
3.
go back to reference McCarty EC, Mencio GA, Walker LA, Green NE (2000) Ketamine sedation for the reduction of children’s fractures in the emergency department. J Bone Joint Surg Am 82-A:912–918PubMed McCarty EC, Mencio GA, Walker LA, Green NE (2000) Ketamine sedation for the reduction of children’s fractures in the emergency department. J Bone Joint Surg Am 82-A:912–918PubMed
4.
go back to reference Dée W, Klein W, Rieger H (2000) Reduction techniques in distal radius fractures. Injury 31(Suppl 1):48–55PubMedCrossRef Dée W, Klein W, Rieger H (2000) Reduction techniques in distal radius fractures. Injury 31(Suppl 1):48–55PubMedCrossRef
5.
go back to reference Durston W, Swartzentruber R (2000) Ultrasound guided reduction of pediatric forearm fractures in the ED. Am J Emerg Med 18(1):72–77PubMedCrossRef Durston W, Swartzentruber R (2000) Ultrasound guided reduction of pediatric forearm fractures in the ED. Am J Emerg Med 18(1):72–77PubMedCrossRef
6.
go back to reference Proctor MT, Moore DJ, Paterson JM (1993) Redisplacement after manipulation of distal radial fractures in children. J Bone Joint Surg Br 75:453–454PubMed Proctor MT, Moore DJ, Paterson JM (1993) Redisplacement after manipulation of distal radial fractures in children. J Bone Joint Surg Br 75:453–454PubMed
7.
go back to reference Shobha Malviya et al (2000) Prolonged recovery and delayed side effects of sedation for diagnostic imaging studies in children. Pediatrics 105(3):e42, MarchCrossRef Shobha Malviya et al (2000) Prolonged recovery and delayed side effects of sedation for diagnostic imaging studies in children. Pediatrics 105(3):e42, MarchCrossRef
8.
go back to reference Lee SMK, Orlinsky M, Chan LS (1994) Safety and effectiveness of portable fluoroscopy in the emergency department for the management of distal extremity fractures. Ann Emerg Med 24:725–730PubMedCrossRef Lee SMK, Orlinsky M, Chan LS (1994) Safety and effectiveness of portable fluoroscopy in the emergency department for the management of distal extremity fractures. Ann Emerg Med 24:725–730PubMedCrossRef
9.
go back to reference Brenner DJ, Doll R, Goodhead DT et al (2003) Cancer risks attributable to low doses of ionizing radiation: assessing what we really know. Proc Natl Acad Sci USA 100(24):13761–13766PubMedPubMedCentralCrossRef Brenner DJ, Doll R, Goodhead DT et al (2003) Cancer risks attributable to low doses of ionizing radiation: assessing what we really know. Proc Natl Acad Sci USA 100(24):13761–13766PubMedPubMedCentralCrossRef
10.
go back to reference Richard Lanoix MD et al (2000) A preliminary evaluation of emergency ultrasound in the setting of an emergency medicine training program. Am J Emerg Med 18(1):41–45, JanuaryCrossRef Richard Lanoix MD et al (2000) A preliminary evaluation of emergency ultrasound in the setting of an emergency medicine training program. Am J Emerg Med 18(1):41–45, JanuaryCrossRef
Metadata
Title
Ultrasound as an aid for reduction of paediatric forearm fractures
Authors
Christopher Ern-Yoong Wong
Angelina Su-Yin Ang
Kee-Chong Ng
Publication date
01-12-2008
Publisher
Springer Berlin Heidelberg
Published in
International Journal of Emergency Medicine / Issue 4/2008
Print ISSN: 1865-1372
Electronic ISSN: 1865-1380
DOI
https://doi.org/10.1007/s12245-008-0072-9

Other articles of this Issue 4/2008

International Journal of Emergency Medicine 4/2008 Go to the issue