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| Diagnostic value of ultrasound in children with fracture of the distal ulna and radius |
| WU Xing LI Xiongtao XIA Jingdong CHENG Xiaoliang ZHOU Zhiguo ZHANG Ping SHEN Xiantao |
| Department of Orthopedics, Wuhan Children′s Hospital, Tongji Medical College，Huazhong University of Science & Technology, Hubei Province, Wuhan 430000, China |
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Abstract Objective To evaluate the diagnostic value of ultrasound in children with suspected fracture of the distal ulna and radius. Methods A total of 131 children with suspected fracture of the distal ulna and radius were admitted to the emergency Department of Orthopedics, Wuhan Children′s Hospital, Tongji Medical College， Huazhong University of Science & Technology, from January to June 2018. Emergency pediatric orthopedic surgeons performed ultrasound examination first and then completed routine X-ray examination of children with suspected fracture of the distal ulna and radius. The results of both tests were blind. The diagnostic sensitivity, specificity, accuracy, positive predictive value, negative predictive value and area under the receiver operating characteristic curve (ROC) of ultrasound in children′s fracture of the distal ulna and radius were evaluated using X-ray as the standard control. Results Ultrasound examination confirmed 55 cases of fracture of the distal ulna and radius, including 36 cases of fracture of distal radius, 16 cases of double of fracture of the distal ulna and radius and 3 cases of fracture of distal ulnar. The sensitivity and specificity of ultrasound examination for the diagnosis of fracture of the distal ulna and radius were 93.1% and 98.6%, respectively, with an accuracy of 96.2%, a positive predictive value of 98.2% and a negative predictive value of 94.7%. There was no significant difference in the positive rate of ultrasound diagnosis and X-ray diagnosis (χ2=0.8, P = 0.371), and the consistency of ultrasound diagnosis and X-ray diagnosis was good (Kappa = 0.922, P ＜ 0.001). The area under ultrasonic ROC was 0.959 (95%CI = 0.917-1.000). Conclusion Ultrasound has high sensitivity and specificity in diagnosing fracture of the distal ulna and radius. Therefore, ultrasound is an alternative diagnostic test for the diagnosis of fracture of the distal ulna and radius in children.
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