Use of Ultrasound for Diagnosis of Clavicle Fractures in the Emergency Department

Abstract

Background: Plain radiography is the method for diagnosing the fracture of the clavicle. The use of US to diagnose clavicle fracture has several advantages when compared to radiography. It could prevent the patient from radiation exposure, especially in vulnerable populations. It may also expedite the diagnosis and decrease the length of stay in the ED. In this study we aimed to discuss the diagnostic success of ultrasonography versus x-ray. Materials and Method: All patients admitted to the emergency department with a shoulder trauma were investigated for their eligibility to be included in the study. A standardized ultrasonography performed by the same investigator to vizualise clavicle from sternal junction through acromial junction. After ultrasonography, plain radiography was performed. Results: The mean age was 45.53 (min = 18; max = 86; SD = 18.791) years and 72.7% were male. Among all patients, 42 clavicula fractures were detected via graphy and 26 (62%) were seen in males and 57 patients with no clavicle fractures. The sensitivity of US to radiographically detected fracture was 92.86% (95%CI, 80.52% to 98.5%), and the specificity was 98.25% (95% CI = 90.61% to 99.96%). The PPV was 97.5% (84.8% to 99.63%) and the NPV was 94.92% (95% CI = 86.23% to 98.23%). Conclusions: Ultrasonography is a good alternative for diagnosing clavicle fracture. Future studies should examine the use of ultrasonography as a method for diagnosing of clavicle fracture by emergency physicians with only basic ultrasonographic training.