POCUS in long bone fractures

CJEM Infographic: Use of POCUS in long bone fractures: a systematic review and meta-analysis

In Infographics, Medical Concepts by Simon Huang3 Comments

This month CanadiEM is featuring an article from the Canadian Journal of Emergency Medicine (CJEM) that looks at the use of point-of-care ultrasound (POCUS) in assessing long bone fractures (LBFs).1 The diagnosis and assessment of LBFs post-reduction is traditionally accomplished through plain radiographs taken at perpendicular angles to each other. However, some studies have suggested PoCUS may be used as a viable alternative.

To address this question, Chartier et al. performed a systematic review and meta-analysis of the literature. Based on inclusion and exclusion criteria, a total of 30 articles were included in the systematic review.Across 30 articles, they found that POCUS had a sensitivity and specificity for the diagnosis of long bone fractures of 64.7-100% and 79.2-100% respectively. By contrast, the sensitivity and specificity of POCUS in assessing post-reduction alignment was found to be 94-100% and 56-100% respectively. In addition to the systematic review, two meta-analyses were performed for two subpopulations of patients: pediatric forearm and adult ankle fractures. The pooled sensitivity and specificity for diagnosing pediatric forearm fracture by POCUS was found to be 93.1% and 89.5% respectively. For adult ankle fractures, the pooled sensitivity and specificity was 89.5% and 94.2% respectively.

Overall, this study shows that POCUS has good accuracy for the diagnosis and reduction alignment of LBFs in all cases and could be used as a reasonable alternative in certain settings.

Download the PDF!


Chartier L, Bosco L, Lapointe-Shaw L, Chenkin J. Use of point-of-care ultrasound in long bone fractures: a systematic review and meta-analysis. CJEM. 2017;19(2):131-142. [PubMed]
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Simon Huang

Simon Huang

Simon Huang is a PGY1 FRCP-EM resident at Dalhousie University. He is the Associate Social Media Editor for CJEM and is involved with infographic creation for the CanadiEM website.
Simon Huang
- 2 years ago