title: The value of point-of-care ultrasound for detecting nail bed injury in ED.
abstract: OBJECTIVE
  The aim of this study is to detect the value of point-of-care ultrasound (POCUS) for diagnosing a nail bed injury and fracture of distal phalanx in patients presenting with distal finger trauma to the emergency department (ED).
  
  
  METHODS
  Patients, 18 to 65 years old, presenting with a blunt trauma of distal finger and diagnosed with subungual hematoma were eligible for the study. Subungual hematoma extending over more than 50%, fracture of distal phalanx, and disruption of periungual tissue or nail integrity were accepted as the indications for nail bed inspection. All the study patients underwent POCUS to detect the existence of a distal phalanx fracture or nail bed injury. X-ray was also obtained from all the patients.
  
  
  RESULTS
  Nail bed was visualized in 45 patients. Squeezing and crush injury were the most reported trauma mechanism in study patients (66.7%). The sensitivity and specificity of POCUS in detecting nail bed injury were 93.4% (95% CI, 80%-99%) and 100% (95% CI, 74%-100%), respectively. The sensitivity was 100% (95% CI, 79%-100%), and specificity was 98.4% (95% CI, 91%-100%) for distal phalanx fracture.
  
  
  CONCLUSIONS
  Point-of-care ultrasound is a promising tool in detecting the nail bed injury and distal phalanx fractures in patients presented with distal finger trauma. Further studies with bigger sample size are needed to reveal the diagnostic ability of POCUS before using it regularly in the ED.
authors.affiliation: Department of Emergency Medicine, Antalya Training and Research Hospital, Antalya, Turkey. Electronic address: drfarukgungor@gmail.com.
authors.forename: Faruk
authors.initials: F
authors.lastname: Gungor
authors.affiliation: Department of Emergency Medicine, Antalya Training and Research Hospital, Antalya, Turkey. Electronic address: drcanakyol@gmail.com.
authors.forename: Kamil Can
authors.initials: KC
authors.lastname: Akyol
authors.affiliation: Department of Emergency Medicine, Akdeniz University Medical Faculty, Antalya, Turkey. Electronic address: cenkereken@akdeniz.edu.tr.
authors.forename: Cenker
authors.initials: C
authors.lastname: Eken
authors.affiliation: Department of Emergency Medicine, Antalya Training and Research Hospital, Antalya, Turkey. Electronic address: mustafakesapli@hotmail.com.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Kesapli
authors.affiliation: Department of Emergency Medicine, Antalya Training and Research Hospital, Antalya, Turkey. Electronic address: inan_beydilli@hotmail.com.
authors.forename: Inan
authors.initials: I
authors.lastname: Beydilli
authors.affiliation: Department of Emergency Medicine, Antalya Training and Research Hospital, Antalya, Turkey. Electronic address: drmehmetakcimen@gmail.com.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Akcimen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004636:Emergency Service, Hospital; D005260:Female; D005383:Finger Injuries / Q000175:diagnosis*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009262:Nails / Q000000981:diagnostic imaging / Q000293:injuries*; D010865:Pilot Projects; D019095:Point-of-Care Systems; D011446:Prospective Studies; D015203:Reproducibility of Results; D014463:Ultrasonography / Q000379:methods*; D055815:Young Adult