The use of a tuning fork and stethoscope to identify fractures.
BACKGROUND
Nonradiographic tests to identify fractures rely on a patient's report of increased pain at the site of injury. These tests can be misleading and produce false-positive or false-negative results because of differences in pain tolerance. A painless technique using a tuning fork and stethoscope to detect fractures has undergone limited review in the athletic training literature.


OBJECTIVE
To determine if the use of a 128-Hz vibrating tuning fork and stethoscope were effective in identifying fractures.


METHODS
Cross-sectional study.


METHODS
University athletic training room or local orthopaedic center when fractures were suspected.


METHODS
A total of 37 patients (19 males, 18 females) volunteered.


METHODS
A diminished or absent sound arising from the injured bone as compared with the uninjured bone represented a positive sign for a fracture. Radiographs interpreted by the attending orthopaedic physician provided the standard for comparison of diagnostic findings.


RESULTS
Sensitivity was 0.83 (10:12), specificity was 0.80 (20:25), positive likelihood ratio was 4.2, negative likelihood ratio was 0.21, and diagnostic accuracy was 81% (30:37).


CONCLUSIONS
The tuning fork and stethoscope technique was an effective screening method for a variety of fractures.
Moore
Michael Bryan
MB
Radford University, Radford, VA, USA. mbmoore@radford.edu