How do clinical features help identify paediatric patients with fractures following blunt wrist trauma?

Emergency Medicine Journal : EMJ
A P WebsterD Burke

Abstract

Wrist injuries are a common presentation to the emergency department (ED). There are no validated decision rules to help clinicians evaluate paediatric wrist trauma. This study aimed to identify which clinical features are diagnostically useful in deciding the need for a wrist radiograph, and then to develop a clinical decision rule. This prospective cohort study was carried out in the ED of Sheffield Children's Hospital. Eligible patients were recruited if presenting within 72 hours following blunt wrist trauma. A standardised data collection form was completed for all patients. The outcome measure was the presence or absence of a fracture. Univariate analysis was performed with the chi2 test. Associated variables (p<0.2) were entered into a multivariate model. Classification and regression tree (CART) analysis was used to derive the clinical decision rule. In total, 227 patients were recruited and 106 children were diagnosed with fractures (47%). Of 10 clinical features analysed, six were found by univariate analysis to be associated with a fracture. CART analysis identified the presence of radial tenderness, focal swelling, or an abnormal supination/pronation as the best discriminatory features. Cross fold validation of this...Continue Reading

References

Feb 11, 1982·The New England Journal of Medicine·D A BrandT R Light
Mar 27, 1999·Annals of Emergency Medicine·I G Stiell, G A Wells
Oct 3, 1999·Journal of Accident & Emergency Medicine·C LibettaJ Yassa
Mar 1, 2000·Statistics in Medicine·D G Altman, P Royston
Oct 4, 2000·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·J PershadL Zinkan
Mar 10, 2005·European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine·Abdullah S Al-AdhamiThomas F Beattie

❮ Previous
Next ❯

Citations

Dec 17, 2009·BMC Medical Research Methodology·Javier TrujillanoAngel Rodriguez-Pozo
Jul 16, 2011·Artificial Intelligence in Medicine·Chun-Ling Chuang
Sep 18, 2007·The American Journal of Emergency Medicine·Elizabeth DillardThomas J Esposito
Apr 9, 2015·International Journal of Emergency Medicine·Anne Brants, Michiel A IJsseldijk
Aug 7, 2013·Injury·Crispijn L van den BrandSteven J Rhemrev
May 3, 2014·Sports Health·Sara J GouldStephen A Gould
Apr 11, 2013·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Nikita JoshiRichard Sinert
Mar 2, 2017·Pediatric Radiology·Marjolein A M MuldersNiels W L Schep
Jul 12, 2018·Pediatric Radiology·Marjolein A M MuldersNiels W L Schep
Jan 26, 2018·Pediatric Emergency Care·Chiara ZanchiEgidio Barbi
Aug 24, 2011·Pediatrics·Jonathon L MaguirePatricia C Parkin

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.