Use of Ultrasound for Diagnosis of Clavicle Fractures in the Emergency Department
1Emergency Medicine Department, Marmara University School of Medicine Pendik Training and Research Hospital, Istanbul, Turkey
DOI: 10.22514/sv.2020.16.0046 Vol.17,Issue 1,January 2021 pp.139-142
Published: 08 January 2021
Background: Plain radiography is the method for diagnosing the fracture of the clavicle. The use of US to diagnose clavicle fracture has several advantages when compared to radiography. It could prevent the patient from radiation exposure, especially in vulnerable populations. It may also expedite the diagnosis and decrease the length of stay in the ED. In this study we aimed to discuss the diagnostic success of ultrasonography versus x-ray. Materials and Method: All patients admitted to the emergency department with a shoulder trauma were investigated for their eligibility to be included in the study. A standardized ultrasonography performed by the same investigator to vizualise clavicle from sternal junction through acromial junction. After ultrasonography, plain radiography was performed. Results: The mean age was 45.53 (min = 18; max = 86; SD = 18.791) years and 72.7% were male. Among all patients, 42 clavicula fractures were detected via graphy and 26 (62%) were seen in males and 57 patients with no clavicle fractures. The sensitivity of US to radiographically detected fracture was 92.86% (95%CI, 80.52% to 98.5%), and the specificity was 98.25% (95%CI = 90.61% to 99.96%). The PPV was 97.5% (84.8% to 99.63%) and the NPV was 94.92% (95% CI = 86.23% to 98.23%). Conclusions: Ultrasonography is a good alternative for diagnosing clavicle fracture. Future studies should examine the use of ultrasonography as a method for diagnosing of clavicle fracture by emergency physicians with only basic ultrasonographic training.
Trauma, Clavicle fracture, Ultrasonography
Sinan Karacabey,Erkman Sanrı. Use of Ultrasound for Diagnosis of Clavicle Fractures in the Emergency Department. Signa Vitae. 2021. 17(1);139-142.
 Control CfD, Prevention. National Hospital Ambulatory Medical Care Survey: 2010 Emergency Department Summary Tables. Centers for Disease Control and Prevention. 2016.
 Herteleer M, Winckelmans T, Hoekstra H, et al. Epidemiology of clavicle fractures in a level 1 trauma center in Belgium. Eur J Trauma Emerg Surg. 2018;44:717-726.
 Wiesel B, Nagda S, Mehta S, et al. Management of midshaft clavicle fractures in adults. J Am Acad Orthop Surg. 2018;26:e468-e476.
 Anderson K. Evaluation and treatment of distal clavicle fractures. Clin Sports Med. 2003;22:319-326, vii.
 Dogan S, Kalafat UM, Yüksel B, et al. Use of radiography and ultrasonography for nasal fracture identification in children under 18 years of age presenting to the ED. Am J Emerg Med. 2017;35:465-468.
 Park YH, Jung RB, Lee YG, et al. Does the use of bedside ultrasonogra-phy reduce emergency department length of stay for patients with renal colic?: a pilot study. Clin Exp Emerg Med. 2016;3:197-203.
 McNeil CR, McManus J, Mehta S. The accuracy of portable ultrasonog-raphy to diagnose fractures in an austere environment. Prehosp Emerg Care. 2009;13:50-52.
 Marshburn TH, Legome E, Sargsyan A, et al. Goal-directed ultrasound in the detection of long-bone fractures. J Trauma. 2004;57:329-332.
 Cross KP, Warkentine FH, Kim IK, et al. Bedside ultrasound diagnosis of clavicle fractures in the pediatric emergency department. Acad Emerg Med. 2010;17:687-693.
 Chien M, Bulloch B, Garcia-Filion P, et al. Bedside ultrasound in the diagnosis of pediatric clavicle fractures. Pediatr Emerg Care. 2011;27:1038-1041.
 Patten RM, Mack LA, Wang KY, et al. Non-displaced fractures of the greater tuberosity of the humerus: sonographic detection. Radiology. 1992;182:201-204.
 Weinberg ER, Tunik MG, Tsung JW. Accuracy of clinician-performed point-of-care ultrasound for the diagnosis of fractures in children and young adults. Injury. 2010;41:862-868.
 Chen L, Kim Y, Moore CL. Diagnosis and guided reduction of forearm fractures in children using bedside ultrasound. Pediatr Emerg Care. 2007;23:528-531.
 Moritz J, Berthold L, Soenksen S. Ultrasound in diagnosis of fractures in children: unnecessary harassment or useful addition to X-ray? Ultraschall Med. 2008;29:267-274.
 Ekþioðlu F, Altýnok D, Uslu MM. Ultrasonographic findings in pediatric fractures. Turk J Pediatr. 2003;45:136-140.
 Sferopoulos N. Fracture separation of the medial clavicular epiphysis: ultrasonography findings. Arch Orthop Trauma Surg. 2003;123:367-369.
 Katz R, Landman J, Dulitzky F, et al. Fracture of the clavicle in the newborn. An ultrasound diagnosis. J Ultrasound Med. 1988;7:21-23.
 Blab E, Geissler W, Rokitansky A. Sonographic management of infantile clavicular fractures. Pediatr Surg Int. 1999;15:251-254.
Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,200 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.
Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.
Chemical Abstracts Service Source Index The CAS Source Index (CASSI) Search Tool is an online resource that can quickly identify or confirm journal titles and abbreviations for publications indexed by CAS since 1907, including serial and non-serial scientific and technical publications.
IndexCopernicus The Index Copernicus International (ICI) Journals database’s is an international indexation database of scientific journals. It covered international scientific journals which divided into general information, contents of individual issues, detailed bibliography (references) sections for every publication, as well as full texts of publications in the form of attached files (optional). For now, there are more than 58,000 scientific journals registered at ICI.
Geneva Foundation for Medical Education and Research The Geneva Foundation for Medical Education and Research (GFMER) is a non-profit organization established in 2002 and it works in close collaboration with the World Health Organization (WHO). The overall objectives of the Foundation are to promote and develop health education and research programs.
Scopus Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.
Embase Embase (often styled EMBASE for Excerpta Medica dataBASE), produced by Elsevier, is a biomedical and pharmacological database of published literature designed to support information managers and pharmacovigilance in complying with the regulatory requirements of a licensed drug.