Evaluation of Diagnostic Value of Clinical Ultrasonography Compared to Radiography in the Diagnosis of Metacarpal Fractures in the Emergency

Metacarpal and finger fractures are the most common upper organ injuries in the emergency. The hand is one of the most important and effective part in this organ. Diagnosis and treatment for these organs are crucial until complete recovery. The aim of this study was to evaluate the diagnostic value of ultrasonography compared to radiography in the diagnosis of metacarpal fractures in the emergency departments of the hospitals Kosar and Be'sat in Sanandaj during the years 2016-2017.

In this cross-sectional study, patients that referred to the emergency with clinical suspicion of metacarpal fracture were evaluated. Clinical, ultrasound, and radiographic findings of the patient were completed by a checklist. Kappa agreement test was used to investigate the relationship between findings of sonographic and radiographicand sensitivity, specificity, positive predictive value, negative predictive value of two methods calculated by using SPSS v.24 software. 

In this study, 73 patients were evaluated, 57 (78.1%) were male and 16 (21.9%) were female. Sensitivity, specificity, positive and negative predictive value related to radiography in diagnosis of metacarpal fractures were 84.2%, 88.5%, 83.5%, and 89.8%, respectively. There was a significant relationship between sonographic and radiographic findings. The kappa value is 0.78 in the direct direction.  

Due to the high sensitivity and specificity of ultrasound in cases with a suspicion of fracture, ultrasound results are faster, cheaper, non-invasive and repeatable in the emergency departmentand Fast ultrasound (FAST) can be performed.