Sürdürülebilir Kalkınma Amaçları

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• MakaleYalnız künye2017/r/gumushane/16450
  The efficiency of bedside ultrasonography in patients with wrist injury and comparison with other radiological imaging methods: A prospective study

  Oguz, Ahmet Burak; Polat, Onur; Eneyli, Muge Gunalp; Gulunay, Behnan; Eksioglu, Merve; Gurler, Serdar

  Study objective: Our aim was to determine the efficiency of ultrasound (US) scanning in patients with wrist trauma admitted to the emergency department and to compare US diagnostic usagewith other radiological imagingmethods. Methods: Patients who presented to the emergency department with wrist injury and who met the inclusion criteria and exclusion criteria were eligible. For all patients, US evaluation of thewhole wristwas performed by an emergency physician before other radiological imagingmethods (radiographies, computed tomography (CT) and magnetic resonance (MR) imaging). All of the patients included in the study underwent US, radiography, CT, and MR. Results: During the study, 122 patients were admitted with a wrist injury. After filtering for the exclusion criteria, 80 patients were included in the study. The sensitivity of US scanning in detecting fractures was 95.31% (95% confidence interval [CI]: 87.1-98.39), the specificity was 93.75% (95% CI: 71.67-98.89), and the positive predictive value was 98.39% (95% CI: 91.72-99.85), and the negative predictive value was 83.33% (95% CI: 72.98-90.41). The sensitivity of US scanning in detecting tendon and ligamentous structural injury was 66.67% (95% CI: 41.71-84.82), the specificity was 100% (95% CI: 94.42-100), the positive predictive valuewas 100% (95% CI: 94.29-99.89), and the negative predictive was 92.86% (95% CI: 84.25-97.14). Conclusion: US scanning is an effective method that can be applied in the emergency department to adult patients to diagnose distal forearm and carpal bones fractures. In soft tissue injuries, US and MR examinations produce similar results. (C) 2017 Elsevier Inc. All rights reserved.

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• MakaleYalnız künye2016/r/gumushane/10666
  A study to develop clinical decision rules for the use of radiography in wrist trauma: Karadeniz wrist rules

  Karaca, Yunus; Turkmen, Suha; Cansu, Aysegul; Baki, Mehmet Emre; Eroglu, Oguz; Tatli, Ozgur; Gunaydin, Mucahit; Beyhun, Ercument; Gunduz, Abdulkadir; Eryigit, Umut

  Introduction: The aim of this study was to evaluate patients presenting to the emergency department (ED) with wrist trauma using physical examination findings and functional tests and to identify findings with high sensitivity and specificity among the parameters assessed in patients with fracture in the wrist. The ultimate objective was thus to establish a reliable and widely usable clinical decision rule for determining the necessity of radiography in wrist trauma. Methods: This prospective, multicenter study was performed in 8 hospitals. The relation between radiologically determined fracture and clinical findings consisting of physical examination findings and functional tests was assessed in terms of whether or not these were markers of radiography requirement, with the aim of identifying predictive values for fracture. Results: A total of 603 eligible trauma patients presented to the participating EDs during the study period. Fracture was identified in 24.5% of patients (n= 148). The 4-way combination with the highest sensitivity was identified as axial compression and the positive distal radioulnar drawer test, and pain with radial deviation and dorsal flexion. Sensitivity at distal ulna palpation was added as a fifth parameter, and sensitivity and negative predictive value thus increased to 100%. Conclusion: With their 100% sensitivity and 100% negative predictive values, the Karadeniz wrist rules may represent a clinical decision rule that can be used in practice in EDs. If all 5 findings are negative, there is no indication for wrist radiography. (C) 2016 Elsevier Inc. All rights reserved.

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