The role of ultrasonography in the diagnosis of metacarpal fractures

Salih Kocaoğlu, Ayhan Özhasenekler, Ferhat İçme, Gül Pamukçu Günaydın, Alp Şener, Şervan Gökhan
American Journal of Emergency Medicine 2016, 34 (9): 1868-71

INTRODUCTION: The aim of this study was to evaluate the efficiency of ultrasonography (USG) in identifying metacarpal bone fractures in patients admitted to the emergency department (ED) with hand injury.

MATERIALS AND METHODS: Patients who were admitted to a training and research hospital's ED during the study period with hand trauma and had suspected metacarpal fractures were included in the study. They were examined for metacarpal fracture by USG and x-ray. Hand radiographs reviewed by an emergency physician were considered to be the criterion standard diagnostic tool. Ultrasonography results were compared to x-ray results.

RESULTS: Ninety-eight ultrasound examinations were performed on 96 adult patients who were enrolled in the study. The mean age of the patients was 30.1±11.8 years; 79.2% of the patients were male. Right hand injury was observed in 69.4% of the cases. Forty metacarpal fractures were detected in 38 patients on x-ray. We found a sensitivity of 92.5% (95% confidence interval [CI], 78.5-98), a specificity of 98.28% (95% CI, 89.5-99.9), a positive predictive value of 97.37% (95% CI, 84.5-99.8), and a negative predictive value of 95% (95% CI, 85-98) for USG to detect metacarpal fractures when compared to x-ray imaging.

CONCLUSIONS: Under the light of these results, we suggest that USG may be an option for detecting metacarpal fractures and prevent unnecessary x-ray imaging examinations in patients presenting to the ED with hand trauma.

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