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| Format: | Recurso digital |
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| Udgivet: |
Zenodo
2026
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| Online adgang: | https://doi.org/10.5281/zenodo.19329625 |
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Indholdsfortegnelse:
- <div> <div> <p><strong>Background</strong>: Distal extremity fractures account for a significant proportion of emergency department (ED) presentations, and conventional radiography carries a well-documented miss rate for small bones of the hand and foot. The waterbath point-of-care ultrasound (POCUS) technique is a novel, painless, radiation-free approach that may improve diagnostic accuracy. This study evaluated the diagnostic accuracy of waterbath POCUS compared to conventional radiography for distal extremity fractures in a South Indian tertiary care emergency setting.</p> <p><strong>Methods</strong>: A prospective diagnostic accuracy study was conducted at Government Medical College, Pudukkottai, Tamil Nadu from November 2023 to October 2024. One hundred adults (≥18 years) presenting with suspected distal extremity fractures were enrolled using a random 4-hour time-block method. POCUS waterbath technique was performed using a 7–13 MHz linear probe and compared to radiologist-interpreted radiography (gold standard). Sensitivity, specificity, likelihood ratios, predictive values, accuracy, and time-to-diagnosis were calculated with 95% confidence intervals (CI).</p> <p><strong>Results</strong>: Mean age was 42.4 ± 15.9 years; 75% were male. Road traffic accidents were the dominant injury mechanism (75%). Fracture prevalence was 64%. Phalanges (29.7%) and metacarpals (21.9%) were the commonest fracture sites. Overall: sensitivity 95.30% (95% CI: 86.90–99.00%), specificity 88.90% (73.90–96.90%), PPV 93.80%, NPV 91.40%, accuracy 93.00%. Hand fractures: sensitivity 100%, accuracy 98.4%. Foot fractures: sensitivity 87%, accuracy 83.8%. Mean diagnosis time: 13.4 ± 2.57 min (POCUS) vs. 27.8 ± 6.08 min (X-ray).</p> <p><strong>Conclusion</strong>: Waterbath POCUS demonstrates high diagnostic accuracy for distal extremity fractures, with excellent performance for hand injuries and a time-to-diagnosis advantage exceeding 50% over conventional radiography. It is a reliable, radiation-free bedside adjunct suitable for high-volume emergency settings.</p> </div> </div> <div></div>