44: Risk Factors for Delayed Analgesia in Patients Presenting to the Emergency Department With Long Bone Fractures

2009 ◽  
Vol 54 (3) ◽  
pp. S15
Author(s):  
J. Mejia ◽  
F. Bautista ◽  
N. Garg ◽  
V. Reddy ◽  
M.S. Radeos ◽  
...  
2009 ◽  
Vol 37 (2) ◽  
pp. 231
Author(s):  
J. Mejia ◽  
F. Bautista ◽  
N. Garg ◽  
A.C. Caligiuri ◽  
V. Reddy ◽  
...  

2011 ◽  
Vol 26 (S1) ◽  
pp. s159-s159
Author(s):  
T.P. Sinha ◽  
S. Bhoi ◽  
A. Bhasin ◽  
M. Rodha ◽  
S. Kumar

BackgroundRadiography is the standard observation tool for examining orthopedic injuries. Bedside Ultrasound (BUS) may be a faster, non-invasive alternative to effectively identify bone fractures in the emergency department (ED) setting. The study compares the diagnostic utilities of BUS and radiography for identifying long bone fractures.MethodsProspective observation study with convenience sampling was conducted in ED in patients > 5 years, with post-traumatic upper and lower limb injuries requiring standard radiological examination after informed consent. The BUS examinations were performed by a emergency physician (EP) who had a brief training session to detect fractures. For every subject, radiographs were taken and reviewed for the presence of fracture by blinded orthopedic specialist. Statistical analysis was done by SPSS.ResultsA total of 133 patients were enrolled in the study. Only 42 had fracture, out of which 36 were picked up by BUS. The overall sensitivity of the BUS in detecting fracture was 85.7% with a confidence interval (CI) of 0.70–0.94 and specificity of 100% with a CI = 0.95–1.00. The positive predictive value (PPV) of USG was 100% with a CI = 0.86–1.00 and negative predictive value (NPV) of 93.8% with a CI = 0.86–0.97. There were six additional fractures which were recognized on x-ray and were not picked up by ultrasound.ConclusionsBUS can be utilized by EP after brief training to accurately identify long-bone fractures. It may gain a more prominent role in pregnant and pediatric population as well as in mass-casualty scenarios.


Author(s):  
Tolulope O. Ogunrewo ◽  
Olugboyega A. Oyewole ◽  
Richard A. Omoyeni ◽  
Mosimabale J. Balogun ◽  
Michael O. Okunola

<p class="abstract"><strong>Background:</strong> Individuals within the paediatric age group sustain different types of fractures, as such the need to determine the incidence and pattern of long bone fractures among patients 16 years and below admitted through the different wards of admittance of the university college hospital Ibadan.</p><p class="abstract"><strong>Methods:</strong> This was a retrospective hospital-based study involving patients 16 years and below admitted through the accident and emergency department, the children emergency department, the neonatal ward and labour ward of the hospital between January 2013 and December 2018 at the university college hospital Ibadan. Using a proformal completed from the electronically stored data that captured the patient’s history, examination findings, X-ray film and treatment offered which was collected on a weekly basis.<strong></strong></p><p class="abstract"><strong>Results:</strong> 25.13% of the patients reviewed within the study period were paediatric patients. A total of 337 paediatric patients were reviewed. There were 124 female and 213 males with ratio (F:M-1:1.7). The fractures were mostly secondary to fall and road traffic crash accounting for 68.54% and 23.15% respectively. 65.12% of the fractures involve the bone of the upper limbs while 34.98% occur in the bones of the lower limbs. The radius and the ulnar bones are the most affected. Transverse fracture is the most common pattern observed.</p><p class="abstract"><strong>Conclusions:</strong> More than 20% of the reviewed population was in the paediatric age group and the radius and ulnar bones were the most commonly fractured bone in this age group. They usually follow trivial falls.</p>


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