Comparison of sonographic and radiographic findings among children with suspected forearm fractures at Moi Teaching and Referral Hospital, Eldoret Kenya

Abstract

Background: Forearm fractures account for about 36.4% of all paediatric injuries. Plain radiography is the gold standard in the diagnosis of fractures. However, ionising radiation is harmful in children and have up to ten times increased risk of morbidity. Ultrasonography, on the other hand, is radiation free, portable and a quick tool to use.
Objectives: To describe and compare the sonographic and radiographic findings among children with suspected forearm fractures in Moi Teaching and Referral Hospital (MTRH).
Design: Cross-sectional study design from April 2021 to March 2022.
Setting: MTRH.
Participants: 373 participants aged less than 18 years with suspected forearm fractures following trauma.
Interventions: Forearm ultrasound was done prior to radiography using SonoScape ultrasound machine with a linear array transducer 7.5 MHZ to 12 MHZ. Forearm radiograph was done as per the MTRH protocol.
Outcome measures: Continuous variables were summarized using mean and categorical variables were summarized in frequencies and percentages. Sensitivity and specificity were used for comparison.
Results: On x-ray, fractures present were 60.2% with both the radius and ulna bones fractured at 56.0%. The right distal radius was the commonest fracture site at 43.8%. On ultrasonography, fractures diagnosed were 59.2% with both the radius and ulna bones fractured at 57.8%. The right distal radius was the most fractured at 44.6%. The sensitivity and specificity were 92.83% and 92% respectively at 95% confidence interval.
Conclusion: Ultrasonography can be used in the diagnosis of forearm fractures due to its high sensitivity and specificity