scholarly journals The diagnostic accuracy of ultrasonography in determining the reduction success of distal radius fractures

2018 ◽  
Vol 18 (3) ◽  
pp. 111-118
Author(s):  
Ozgur Bozkurt ◽  
Murat Ersel ◽  
Funda Karbek Akarca ◽  
Sercan Yalcinli ◽  
Sadiye Midik ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Distal Radius ◽  
Distal Radius Fractures ◽  
Radius Fractures

scholarly journals P041: Accuracy of medical student-performed point-of-care ultrasound in the diagnosis of distal radius fractures in adults

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S92-S92
Author(s):  
L. Farnell ◽  
A.K. Hall ◽  
C. McKaigney
Keyword(s):  
Medical Students ◽  
Diagnostic Accuracy ◽  
Distal Radius ◽  
Point Of Care ◽  
Distal Radius Fractures ◽  
Point Of Care Ultrasound ◽  
Radiographic Imaging ◽  
Radius Fractures ◽  
Wide Range ◽  
Test Probability

Introduction: Previous investigations of the diagnostic accuracy of point-of-care ultrasound (POCUS) in distal radius fractures (DRF) report a wide range of sensitivities (71%-98%) and specificities (73%-100%) when performed by medical professionals, which may reflect inconsistencies in POCUS training or sonographer experience. The purpose of this study was to determine the accuracy of POCUS performed by pre-clerkship medical students with minimal POCUS training compared to standard radiography in diagnosing DRF in adult patients with traumatic wrist injuries, in order to assess POCUS as an alternative to traditional radiographic imaging. Methods: This prospective observational study was conducted from June to September 2015. The study population consisted of adults presenting to the emergency department (ED) with distal forearm pain secondary to traumatic injury within the past seven days and for whom radiographic imaging was ordered. Patients were evaluated using POCUS performed by medical students with no prior experience who had received one hour of POCUS training taught by an emergency ultrasound fellowship-trained ED physician. A pre-test probability of fracture was stratified as low or high and documented independently by the treating physician. Students were blinded to pre-test probability and radiography results. Results: Of the 52 patients enrolled, 18 had DRF diagnosed by radiographic imaging. Compared to radiography, student-performed POCUS had 72% overall sensitivity (95% CI, 47%-90%) and 85% specificity (95% CI, 69%-95%), with 81% overall accuracy. In the high pre-test probability group (N = 20), POCUS had 80% sensitivity (95% CI, 52%-96%) and 60% specificity (95% CI, 15%-95%). In the low pre-test probability group (N = 32), POCUS had 33% sensitivity (95% CI, 1%-91%) and 90% specificity (95% CI, 73%-98%). Conclusion: POCUS performed by medical students demonstrated reasonable success in diagnosing DRF, with overall sensitivity and specificity in keeping with published data. Within the low pre-test probability group, the diagnostic accuracy of POCUS suggests that ultrasound was an unreliable alternative to radiographic imaging for DRF in this cohort. Future analysis of the factors leading to DRF missed by POCUS as being related to adequacy of POCUS training, image capture, or sonographer experience will further explore the utility of POCUS as a diagnostic alternative.

scholarly journals Artificial intelligence to diagnosis distal radius fracture using biplane plain X-rays

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Kunihiro Oka ◽  
Ryoya Shiode ◽  
Yuichi Yoshii ◽  
Hiroyuki Tanaka ◽  
Toru Iwahashi ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Diagnostic Accuracy ◽  
Distal Radius ◽  
Diagnostic Tests ◽  
Styloid Process ◽  
Final Diagnosis ◽  
Distal Radius Fractures ◽  
X Rays ◽  
Radius Fractures ◽  
X Ray

Abstract Background Although the automatic diagnosis of fractures using artificial intelligence (AI) has recently been reported to be more accurate than those by orthopedics specialists, big data with at least 1000 images or more are required for deep learning of the convolutional neural network (CNN) to improve diagnostic accuracy. The aim of this study was to develop an AI system capable of diagnosing distal radius fractures with high accuracy even when learning with relatively small data by learning to use bi-planar X-rays images. Methods VGG16, a learned image recognition model, was used as the CNN. It was modified into a network with two output layers to identify the fractures in plain X-ray images. We augmented 369 plain X-ray anteroposterior images and 360 lateral images of distal radius fractures, as well as 129 anteroposterior images and 125 lateral images of normal wrists to conduct training and diagnostic tests. Similarly, diagnostic tests for fractures of the styloid process of the ulna were conducted using 189 plain X-ray anteroposterior images of fractures and 302 images of the normal styloid process. The distal radius fracture is determined by entering an anteroposterior image of the wrist for testing into the trained AI. If it identifies a fracture, it is diagnosed as the same. However, if the anteroposterior image is determined as normal, the lateral image of the same patient is entered. If a fracture is identified, the final diagnosis is fracture; if the lateral image is identified as normal, the final diagnosis is normal. Results The diagnostic accuracy of distal radius fractures and fractures of the styloid process of the ulna were 98.0 ± 1.6% and 91.1 ± 2.5%, respectively. The areas under the receiver operating characteristic curve were 0.991 {n = 540; 95% confidence interval (CI), 0.984–0.999} and 0.956 (n = 450; 95% CI 0.938–0.973). Conclusions Our method resulted in a good diagnostic rate, even when using a relatively small amount of data.

The Effect of Volarly Angulated Distal Radius Fractures on Forearm Rotation: In Vitro Biomechanical Study

2015 ◽  
Vol 04 (S 01) ◽  
Author(s):  
Masao Nishiwaki ◽  
Mark Welsh ◽  
Louis Ferreira ◽  
James Johnson ◽  
Graham King ◽  
...  
Keyword(s):  
Distal Radius ◽  
Biomechanical Study ◽  
Distal Radius Fractures ◽  
Radius Fractures ◽  
Forearm Rotation

scholarly journals Minimising the risk of extensor pollicis longus rupture following volar plate fixation of distal radius fractures: a cadaveric study

2011 ◽  
Vol 93 (1) ◽  
pp. 57-60 ◽  
Author(s):  
DC Perry ◽  
DMG Machin ◽  
JA Casaletto ◽  
DJ Brown
Keyword(s):  
High Risk ◽  
Distal Radius ◽  
Plate Fixation ◽  
Tendon Injury ◽  
Distal Radius Fractures ◽  
Volar Plate ◽  
Radius Fractures ◽  
Extensor Pollicis Longus ◽  
Fixed Angle ◽  
Volar Plate Fixation

INTRODUCTION Rupture of extensor pollicis longus (EPL) tendon is a recognised complication following volar plate fixation of distal radius fractures, usually from attrition caused by prominent screws. We sought to identify the screw holes in some of the most commonly used plates which may precipitate tendon injury. SUBJECTS AND METHODS Three fixed-angle volar locking plates were sequentially positioned into 18 cadaveric arms. A wire was passed through each of the holes in the plates using a locking guide and the dorsal relationships noted. RESULTS Each plate had specific ‘high-risk’ holes which directed the wire towards the EPL groove. The central screw holes appeared mostly implicated in EPL injury. CONCLUSIONS Awareness of ‘high-risk’ holes and appropriate minor alterations in surgical technique may consequently decrease the incidence of EPL irritation and rupture.

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