Fracture sonography – Literature review and current recommendations

Abstract

Purpose Over the course of more than two years, an expert group of 9 professional societies has created the S2e guidelines for fracture sonography. This publication summarizes the key points regarding the individual indications.

Materials and Methods A systematic literature search was performed in PubMed, Google Scholar, and the Cochrane Database of Systematic Reviews from 2000 to March 2021 with evaluation of the literature lists. Randomized controlled clinical trials, observational clinical trials, meta-analyses, and systematic reviews were included. Guidelines, conferences, reviews, case reports, and expert opinions were excluded. Evidence was graded using the SIGN grading system 1999–2012, and the SIGN tables were then presented to the expert group. These were used to develop specific recommendations for the use of fracture sonography. All recommendations were discussed in detail and finally unanimously agreed upon.

Results Of the 520 primary literature sources found, 182 sources (146 clinical studies and 36 meta-analyses and systematic reviews) were evaluated after screening and content assessment. 21 indications that allow reasonable application of fracture sonography were identified.

Conclusion Ultrasound is a sensible, easy-to-use diagnostic method that is feasible for a large number of indications.

Zusammenfassung

Einleitung In über 2-jähriger Arbeit hat eine Expertengruppe von 9 Fachgesellschaften die S2e-Leitlinie „Fraktursonografie“ erstellt. Die vorliegende Publikation fasst die zentralen Punkte zu den einzelnen Indikationen zusammen.

Methodik Es erfolgte eine systematische Literaturrecherche in PubMed, Google Scholar und der Cochrane Database of Systematic Reviews aus den Jahren 2000 bis zum März 2021 mit Auswertung der Literaturlisten. Es wurden randomisierte, kontrollierte klinische Tests, klinische Beobachtungsstudien, Meta-Analysen und systematische Reviews eingeschlossen. Ausgeschlossen wurden Leitlinien, Konferenzen, Reviews, Fallberichte und Expertenmeinungen. Die Evidenzbewertung erfolgte nach dem SIGN-Grading-System 1999–2012. Die so erhaltenen SIGN-Tabellen wurden dann der Expertengruppe vorgelegt, die hieraus konkrete Empfehlungen für die Anwendung der Fraktursonografie erarbeitete. Sämtliche Empfehlungen wurden ausführlich diskutiert und zuletzt einstimmig konsentiert.

Ergebnisse Von primär 520 gefundenen Literaturquellen konnten nach Sichtung und inhaltlicher Bewertung 182 Quellen (146 klinische Studien sowie 36 Meta-Analysen und systematische Reviews) ausgewertet werden. Es wurden 21 Indikationen identifiziert, die eine sinnvolle Anwendung der Fraktursonografie erlauben.

Schlussfolgerung Fraktursonografie ist eine sinnvolle Diagnostikmethode bei einer Vielzahl an Indikation.

Keywords

Sonography - METHODS & TECHNIQUES - ultrasound - fracture - bone - diagnosis

Publication History

Received: 27 May 2023

Accepted after revision: 08 December 2023

Article published online:
23 February 2024

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