Evaluation of tendon damage by bedside ultrasonography in patients presenting to the emergency department with hand injury

Introduction and Aim: Hand injuries are among the common causes of applying to the emergency department. Tendon injuries are usually diagnosed by physical examination. Magnetic resonance imaging (MRI) is rarely used in emergency room conditions due to both cost and time constraints. Ultrasonography is becoming a common diagnostic tool due to its mobility, low cost, accessibility in the emergency room, and high clarity and dynamic evaluation. In this study, we aimed to evaluate the effectiveness of USG in the diagnosis of tendon injury in patients admitted to the emergency department due to hand injury. Material and Method: 72 patients aged 16 years and older who applied to the Emergency Medicine Clinic of our hospital between 15.01.2021 and 15.10.2021 were included in our study. Longitudinal and transverse plane imaging was performed preoperatively by a single emergency medicine resident trained in ultrasonography. Afterwards, orthopedics and plastic surgery residents, who had no knowledge of USG findings, were consulted in terms of tendon incision injuries and surgical exploration was accepted as the gold standard method. Demographic characteristics, symptom locations and trauma mechanisms of the patients were recorded in the study form. The data obtained with in the scope of there search were analyzed in the SPSS (Statistical Package for Social Sciences) 26.0 package program. Results: A total of 72 patients, 53 male and 19 female, aged between 16 and 71, with a mean age of 37.6±14.1 years, were included in the study. 166 tendons in 88 sites for tendon injury in 72 patients were examined by USG. In hand injuries, the sensitivity of USG was 90.9%, and the specificity was 86.4%. When looking at the total tendon rupture, the sensitivity of USG was 87.0%, the specificity was 94.6%, the sensitivity of USG for partial tendon rupture was 75.9%, and the specificity was 91.1%. When evaluated for normal tendon imaging, the sensitivity of USG was 92.8% and the specificity was 85.5%. Conclusion: In this study, which we performed in patients admitted to the emergency department due to hand injury, the sensitivity and specificity of USG in tendon examination were found to be high. Ultrasonography has many advantages such as being bedside and easy to apply, providing dynamic images and affordable cost. We think that ultrasonography can be used as an effective diagnostic tool in the diagnosis of tendon injuries in emergency services. Keywords: Emergency department, hand injuries, tendon rupture, ultrasonography