One-liner:
Point-of-care ultrasound was noninferior to radiographs for diagnosing distal forearm buckle fractures while improving patient experience.
Summary:
Background: Distal forearm buckle fractures are among the most common pediatric fractures and are often straightforward to diagnose.
Methods: Multicenter randomized trial comparing ultrasound-first evaluation with conventional radiography (n=270).
Results: Ultrasound accurately diagnosed buckle fractures with similar clinical outcomes. Families reported greater satisfaction, ED length of stay decreased, and radiation exposure was avoided.
Limitations: Requires physician ultrasound training. Results apply primarily to uncomplicated distal forearm injuries.
Clinical Relevance: Supports expanding POCUS use for selected pediatric orthopedic injuries and reducing unnecessary radiographs.
Take-home Points:
POCUS is an effective first-line imaging modality, ideal for experienced ultrasound users.
Shorter ED stays.
Eliminates radiation.
Additional Information
References
Snelling PJ, Jones P, Bade D, Bindra R, Byrnes J, Davison M, George S, Moore M, Keijzers G, Ware RS; BUCKLED Trial Group. Ultrasonography or Radiography for Suspected Pediatric Distal Forearm Fractures. N Engl J Med. 2023 Jun 1;388(22):2049-2057. doi: 10.1056/NEJMoa2213883. PMID: 37256975.