Abstract
Objective
The aim of this study is to detect the value of point-of-care ultrasound (POCUS) for
diagnosing a nail bed injury and fracture of distal phalanx in patients presenting
with distal finger trauma to the emergency department (ED).
Methods
Patients, 18 to 65 years old, presenting with a blunt trauma of distal finger and
diagnosed with subungual hematoma were eligible for the study. Subungual hematoma
extending over more than 50%, fracture of distal phalanx, and disruption of periungual
tissue or nail integrity were accepted as the indications for nail bed inspection.
All the study patients underwent POCUS to detect the existence of a distal phalanx
fracture or nail bed injury. X-ray was also obtained from all the patients.
Results
Nail bed was visualized in 45 patients. Squeezing and crush injury were the most reported
trauma mechanism in study patients (66.7%). The sensitivity and specificity of POCUS
in detecting nail bed injury were 93.4% (95% CI, 80%-99%) and 100% (95% CI, 74%-100%),
respectively. The sensitivity was 100% (95% CI, 79%-100%), and specificity was 98.4%
(95% CI, 91%-100%) for distal phalanx fracture.
Conclusion
Point-of-care ultrasound is a promising tool in detecting the nail bed injury and
distal phalanx fractures in patients presented with distal finger trauma. Further
studies with bigger sample size are needed to reveal the diagnostic ability of POCUS
before using it regularly in the ED.
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Article Info
Publication History
Published online: June 18, 2016
Accepted:
June 15,
2016
Received in revised form:
May 14,
2016
Received:
March 24,
2016
Identification
Copyright
© 2016 Elsevier Inc. All rights reserved.
