[Sonographic diagnostics of proximal humerus fractures in juveniles]

Abstract

Aim of the study: The exact determination of the extent of deformities in juvenile proximal humerus fractures is difficult with plain x-rays. The aim of this study was to find out whether proximal humerus fractures can be diagnosed and the extent of the deformity can be detected by ultrasonography.

Patients and methods: In a prospective, multicentre trial children aged 0-12 years with suspected proximal humerus fractures were examined. Initially a standardized sonographic evaluation was performed and the extent and the direction of the deformity were determined. The recommended treatment was noted. Afterwards standard x-rays were taken and the results of both diagnostic procedures were compared.

Results: A total of 33 children were examined, 14 male and 19 female, with a mean age of 7.6 years. In the ultrasound examination 17 out of 18 proximal humerus fractures were detected. In comparison to x-ray diagnostics ultrasonography proved to have a sensitivity of 94% and a specificity of 100%. In 16 cases ultrasonography gave a better result than x-ray imaging and x-ray was better in 5 cases.

Conclusion: Ultrasonography is suitable for detection and exclusion of fractures and better than x-ray diagnosis for evaluation of the type and direction of deformations of proximal humerus fractures.