Using bedside ultrasound to diagnose forearm fractures in children

Grant ID: EMPJ-222R31-2019-SNELLING

Lay Summary

This is a multicentre, open-labelled diagnostic randomised controlled trial to comparing the use of portable ultrasound and x-ray imaging to diagnose a buckle fracture in children. The trial will determine if there are differences in functional outcomes, patient and care-giver preferences, and health system benefits.

Children frequently present to the emergency department with forearm injuries and often have an x-ray to assess if there is a fracture. Due to the soft and plastic nature of the bones in young children, injuries can cause their bones to bend, known as a buckle fracture. Bedside ultrasound is a test that emergency practitioners can use to rapidly diagnose a fracture at the time of examination, without exposing children to ionising radiation. Ultrasound in this setting is well tolerated, only requiring light touch and gentle manipulation of the forearm and has similar accuracy when compared with x-rays for diagnosing children’s forearm fractures.

This is the first trial of its kind to assess whether an x-ray is unnecessary when there is either a buckle fracture or no fracture seen on a portable ultrasound machine. This is important as they can be treated at the time of review without any further delay, which will avoid these children being exposed to ionising radiation. Children will be randomised to receive either an ultrasound or x-ray for their forearm injury. Both groups will be followed up to see whether there are any differences in their recovery and to determine any complications. We will also determine the time and cost implications of this new approach, which could enable families to go home earlier and could be more cost-effective, with less x-rays being ordered.


SHARE

Amount Awarded
$159,458


Program


Grant Scheme


Status
Active


Principal Investigator:
D Peter Snelling


Co Investigators:
Prof Robert Ware
Prof Gerben Keijzers
A/Prof Joshua Byrnes
Mark Moore
Dr Michelle Davison
Dr Corey Cassidy
Dr David Bade
Dr Randy Bindra


Associate Investigators:
Dr Stuart Watkins
Dr David Herd
Peta Gimpel
Rosemary Rogers
Dr Robert Roan
Dr Shane George
Dr Christopher Carty
Dr Ruaraidh McRitchie


Institution


Collaborating Institutions


CONTACT US +61 7 3720 5700 info@emfoundation.org.au Suite 1B, Terraces, 19 Lang Parade, Milton Qld 4064