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    The comparison of point-of-care ultrasonography and radiography in the diagnosis of tibia and fibula fractures
    (Elsevier Ltd, 2017) Kozacı, Nalan; Ay, Mehmet Oğuzhan; Avcı, Mustafa; Turhan, Sadullah; Donertas, Eda; Çelik, Ahmet; Ararat, Ertan; Akgün, Emrah
    Objective We aimed to compare the efficacy of Point-of-care ultrasonography (POCUS) with radiography in the diagnosis of tibia fracture (TF) and fibula fracture (FF), and determation of fracture characteristics. Methods Patients aged 5–55 years who were admitted to ED due to low-energy, simple extremity trauma, who had a suspected TF and FF on physical examination were included in this prospective study. One physician performed POCUS examination. Other physician evaluated the radiography images. The obtained results were compared. Results A total of 62 patients were included in the study. TF was detected in 21 patients by radiography and in 24 patients by POCUS. FF was detected in 24 patients by radiography and in 25 patients by POCUS. Ten of the patients had both TF and FF. Compared with radiography, sensitivity, specificity, PPV and NPV of POCUS in the detection of TF were 100%, 93%, 88% and 100% (95% CI, 91–100%), respectively. Compared with direct X-ray imaging, sensitivity, specificity, PPV and NPV of POCUS in the detection of FF were 100%, 97%, 96% and 100% (95% CI, 96–100%), respectively. We determined that POCUS is also successful in detection of fracture features such as angulation, step-off, extension into the joint space that can determine the treatment decision. Conclusion This study demonstrated that POCUS was found to be as successful as direct X-ray imaging in the diagnosis of TF and FF. © 2017 Elsevier Ltd
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    The comparison of radiography and point-of-care ultrasonography in the diagnosis and management of metatarsal fractures
    (Elsevier Ltd, 2017) Kozacı, Nalan; Ay, Mehmet Oğuzhan; Avcı, Mustafa; Beydilli, İnan; Turhan, Sadullah; Dönertaş, Eda; Ararat, Ertan
    Objective It was aimed to compare the efficacy of point-of-care ultrasonography (POCUS) with radiography in the diagnosis and management of metatarsal fracture (MTF). Methods Patients aged 5–55 years admitted to emergency room due to low-energy, simple extremity trauma and had a suspected MTF, were included in this prospective study. Patients were evaluated by two different emergency physicians in the emergency room. The first physician performed POCUS examination. Second physician evaluated the radiography images. The obtained results were compared. Results Seventy-two patients were enrolled in the study. Fracture was detected in 39% by radiography and in 43% of patients by POCUS. Multiple MTFs were identified in 5% of patients. Compared with radiography, POCUS had a sensitivity of 93%, specificity of 89%, positive predictive value of 84% and a negative predictive value of 95% (95% CI, 83–98%) in the detection of fractures. While soft tissue edema was seen in 61% of patients by POCUS, soft tissue edema with hematoma was detected in 14%. Compared with radiography, the sensitivity and specificity of POCUS in the decision for surgery were 100% and 98% (95% CI, 97–100%), respectively, whereas its sensitivity and specificity were both 100% in the decision for reduction. Conclusion In our study, we demonstrated that POCUS could be applied with success in the diagnosis and treatment of MTF in low-energy injuries. POCUS can be used as an alternative to radiography in the emergency rooms due to being easy to learn and practice and availability of soft tissue examination along with bone tissue examination. © 2016 Elsevier Ltd