title: Emergency physicians performed Point-of-Care-Ultrasonography for detecting distal forearm fracture.
abstract: OBJECTIVE
  Several studies focusing diagnosis of forearm fracture using Point-of-Care-Ultrasonography (POCUS) had been carried out in children. There is a lack of evidence for the utility of sonographic (US) examination for detecting of distal forearm fracture in adults. We aim to determine the diagnostic sensitivity and specificity of POCUS examination for the fracture of the distal radius and ulna in adult patients presenting with blunt forearm trauma.
  
  
  METHODS
  Adult patients presenting with acute distal forearm trauma and suspicion of fracture were enrolled into study. POCUS had been performed by blinded emergency physicians, than anteroposterior and lateral x-rays was obtained. If inconsistency between x-rays and POCUS has been occurred, computed tomography were ordered. Assessment of orthopedic surgeon was accepted as a gold standard diagnosis.
  
  
  RESULTS
  Ninety three POCUS were performed in 90 patients. Fifty nine radius and 19 ulna fracture had been diagnosed. POCUS detected all radius fracture, but missed 2 ulna fracture. There were 4 false positive results for both radius and ulna with POCUS. X-ray missed 4 radius, and 1 ulna fractures. Diagnostic sensitivity and specificity of POCUS for fracture of ulna were 89.5% (CI%95, 65.5-98.1) and 94.6 (CI%95, 86-98.2), for fracture of radius were 100% (CI%95, 92.4-100), and 88.2%. (CI%95, 71.6-96.1).
  
  
  CONCLUSIONS
  Emergency physician performed POCUS examination is very sensitive and specific the diagnosis of distal forearm fracture. Diagnostic sensitivity of POCUS for radius fracture is higher than x-ray.
authors.affiliation: Dokuz Eylul University School of Medicine, Department of Emergency Medicine, Turkey.
authors.forename: Semra
authors.initials: S
authors.lastname: Sivrikaya
authors.affiliation: Dokuz Eylul University School of Medicine, Department of Emergency Medicine, Turkey.
authors.forename: Ersin
authors.initials: E
authors.lastname: Aksay
authors.affiliation: Dokuz Eylul University School of Medicine, Department of Emergency Medicine, Turkey.
authors.forename: Basak
authors.initials: B
authors.lastname: Bayram
authors.affiliation: Dokuz Eylul University School of Medicine, Department of Emergency Medicine, Turkey.
authors.forename: Nese Colak
authors.initials: NC
authors.lastname: Oray
authors.affiliation: Dokuz Eylul University School of Medicine, Department of Orthopedic Surgery, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Karakasli
authors.affiliation: Dokuz Eylul University School of Medicine, Department of Emergency Medicine, Turkey.
authors.forename: Emel
authors.initials: E
authors.lastname: Altintas
keywords: Emergency departments; Forearm; Fracture; Ultrasonography