Diagnostic accuracy of ultrasound in upper and lower extremity long bone fractures of emergency department trauma patients

Background: Long bone fractures are common injuries caused by trauma. Some studies have demonstrated that ultrasound has a high sensitivity and specificity in the diagnosis of upper and lower extremity long bone fractures. Objective: The aim of this study was to determine the accuracy of ultrasound compared with plain radiography in diagnosis of upper and lower extremity long bone fractures in traumatic patients. Methods: This cross-sectional study assessed 100 patients admitted to the emergency department of Imam Khomeini Hospital, Ahvaz, Iran with trauma to the upper and lower extremities, from September 2014 through October 2015. In all patients, first ultrasound and then standard plain radiography for the upper and lower limb was performed. Data were analyzed by SPSS version 21 to determine the specificity and sensitivity. Results: The mean age of patients with upper and lower limb trauma were 31.43±12.32 years and 29.63±5.89 years, respectively. Radius fracture was the most frequent compared to other fractures (27%). Sensitivity, specificity, positive predicted value, and negative predicted value of ultrasound compared with plain radiography in the diagnosis of upper extremity long bones were 95.3%, 87.7%, 87.2% and 96.2%, respectively, and the highest accuracy was observed in left arm fractures (100%). Tibia and fibula fractures were the most frequent types compared to other fractures (89.2%). Sensitivity, specificity, PPV and NPV of ultrasound compared with plain radiography in the diagnosis of upper extremity long bone fractures were 98.6%, 83%, 65.4% and 87.1%, respectively, and the highest accuracy was observed in men, lower ages and femoral fractures. Conclusion: The results of this study showed that ultrasound compared with plain radiography has a high accuracy in the diagnosis of upper and lower extremity long bone fractures