Functional outcomes for pediatric arm fracture just as good with initial POCUS instead of initial radiography (BUCKLED)

Clinical Question

Is point-of-care ultrasonography noninferior to radiography for suspected distal forearm fracture in children?

Bottom line

Kudos to these researchers for looking beyond accuracy to the impact of a diagnostic test on patient outcomes. POCUS looks like a great option as the initial imaging study of choice for suspected pediatric arm fracture. Of course, as these fractures are quite forgiving, they may do well with just a splint and no imaging at all. 1b

Study design: Randomized controlled trial (nonblinded)

Funding: Foundation

Setting: Emergency department

Reviewer

Mark H. Ebell, MD, MS
Professor
University of Georgia
Athens, GA


Discuss this POEM


Comments

Arup Kumar Dhara

Impact assessment

Excellent

Anonymous

U/S vs/ Xray for paediatric arm fractures

Don't really understand why U/S would be favoured over Xray for these fractures. Xray is quick, cheap, definitive and no risk. U/S however is labour intensive, time consuming and would be more uncomfortable for the child.

Janet Craig

ultrasound versus x-ray for forearm fracture

In the community, we wouldn't be able to get an ultrasound quickly, so would always be doing x-rays.

Anonymous

Not all buckles are just a buckle.

Maybe good screening tool in er but not for long term treatment.
Not all are just “ buckle “ fractures, some go on to significant angulation if no treated properly the first 10 days or so.

Anonymous

FUNCTIONAL OUTCOMES OF PEDIATRIC ARM FRACTURE WITH POCUS

GOOD TO KNOW