Role of US vs X Ray in Detection of Pediatric Elbow Fractures.

NCT ID: NCT05968092

Last Updated: 2023-08-01

Basic Information

• Recruitment Status: UNKNOWN
• Total Enrollment: 52 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2023-08-07
• Study Completion Date: 2024-09-01

Brief Summary

The purpose of this prospective study is to evaluate and compare the accuracy of elbow ultrasonography with X Ray radiography for the diagnosis of elbow fractures in children following trauma in order to detect the validity of US in diagnosis of fractures as a dependent tool.

Detailed Description

Acute bone fractures in children are common and account for 10-25% of total injuries in early ages with considerable effects on activity restriction and subsequent high socioeconomical impact. In these cases, the elbow is a common site of pediatric fractures (account for up to 15% of all fractures) referring to the emergency department, and diagnostic testing with X-ray, including standard 2-way anteroposterior and lateral views, are required primarily for the evaluation of elbow injuries. In the setting of elbow trauma, the posterior fat pad sign on lateral radiographs is highly sensitive for fracture . However, radiological assessment of the elbow may be challenging in early ages due to the non-ossifed epiphysis and often non-exact two- plane radiographs in uncooperative children. Because of the higher sensitivity of growing bones to ionizing radiation, and dose-dependent radiation exposure is both CT scans and X-ray, every imaging should be minimized in children. Therefore, alternative imaging methods, such as US, have become a current issue to reduce exposure to radiation . Ultrasound is radiation-free, it is a real-time bedside assessment, it can be immediately performed and is easily accessible, and it is fast and reliable ,Ultrasonography can detect cortical disruption and irregularity, which directly indicates fractures. However, an elevated posterior fat pad can be easily identified by US, indirectly indicates intracapsular fractures . Ultrasonography is superior to radiography in detecting posterior fat pad elevation. Elbow joint effusion is a classic finding after trauma.

It is not always associated with a cortical fracture, whereas lipohaemarthrosis, corresponding to the presence of blood and lipid material in the posterior fat pad, indicates an intraarticular elbow fracture, too.

Lipohemarthrosis, as well as an elevated posterior fat pad, can easily be identifed on ultrasound.

Conditions

Elbow Fractures

Study Design

• Observational Model Type: CASE_CROSSOVER
• Study Time Perspective: PROSPECTIVE

Eligibility Criteria

Inclusion Criteria

• The patients' age between 7 month and 14 years with a suspected elbow fracture.
• Patients who less than 7 days after the injury of elbow.

Exclusion Criteria

• Patients with a an open injury in elbow.
• Patients with suspected vascular injury.
• Patients with unstable vital signs .

• Minimum Eligible Age: 7 Months
• Maximum Eligible Age: 14 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Assiut University

OTHER

Sponsor Role: lead

Responsible Party

Mariam Mosad Shenouda

Resident doctor

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Mohamed Gabeer, Lecturer

Role: STUDY_DIRECTOR

Assiut University

Hesham Mohammed, Lecturer

Role: STUDY_DIRECTOR

Assiut University

Central Contacts

Mariam Mosad, Master

Role: CONTACT

mariammosad475@gmail.com

01272629579

Ahmed Mostafa, Professor

Role: CONTACT

moustafamanar@gmail.com

01000024182

References

Azizkhani R, Hosseini Yazdi Z, Heydari F. Diagnostic accuracy of ultrasonography for diagnosis of elbow fractures in children. Eur J Trauma Emerg Surg. 2022 Oct;48(5):3777-3784. doi: 10.1007/s00068-021-01648-6. Epub 2021 Mar 24.

Reference Type: BACKGROUND

PMID: 33763708 (View on PubMed)

Other Identifiers

US and X Ray in elbow

Identifier Type: -

Identifier Source: org_study_id