Evaluation of the success of ultrasound-guided reduction of distal radius fractures

AIM: The main purpose of this study is increasing the reduction success of DRF.The secondary aim is decreasing the recurrent procedural sedation and reduction needs. METHOD: This is a randomized control, prospective cross-sectional study.119 patients with deplaced DRF injury, over 18 years old are included in case group.Prereduction fracture Ultrasonography(USG) were performed by observer.Prereduction fracture USG were performed by observer(emergency medicine resident) as dorsal, lateral and horizantal plan.Traction and closed reduction process were obtained by orthopedy residents.Reduction success was controlled by observer before casting.Patients detected as inappropriate reduction referred to orthopedy for revolution.In control group only standart reduction processes were performed without using USG.Post-reduction X-ray films were evaluated by orthopedy whereas USG by observer. FINDINGS: In this study, reduction success of USG-guided process is 76.7%(n=40) whereas by X-ray this rate is 75%(n=45) sensitivity of USG for evaluation of reduction success is 95,7 % and spesifitivity is 92,9 %.Positive predicted value is 97,78 %.Negative predicted value is 86,67 %.In case group 75 % (n:45) of patients fractures were reducted in the first time whereas in control group this rate is only %54,2 (n:32)25 % of case group (n:15) are failed to reducted are remanupulated and 46% of these (n:7) were reducted successfully which means increasing reduction success. DISCUSSION: Reduction success of DRF by using USG was increased parallel to litherature.In DRF by useing USG, prereductional detection of conditions which brings low reduction success(radius shortness, multiple fragment fractures, above 40o dorsal angulation of distal fragment) may be usefull for direct surgery referral.