Diagnostic value of clinical examinations in confirming fracture of elbow bones

Introduction: Fractures and elbow dislocation are one of the most common injuries at different ages,especially in childhood and younger. Its approach to emergency centers is to perform such tests in adiagnosis of fractures or depression. Due to the high volume of the occurrence of such a disaster and itsprobable occurrence, especially in age groups and occupations, the study of radio graphics in any jointdamage not only entails a high cost to the system of treatment, but also the consequences of radiationexposure to the patient. The purpose of this study was to evaluate the value of diagnosis of extension,supination, ecchymosis, hematoma and local tenderness in elbow injury in patients referred to ImamKhomeini Hospital in Sari..Methods: This study is a prognosis test that evaluates the clinical findings of physical examination andimaging results in predicting elbow bone fractures in patients aged between 18 and 60 who suffer fromblunt trauma referring to the emergency department of Imam Hospital. Initially, the first examinations ofthe patient s joint wound were assessed by assessing the range of motion including extension, supination,and pronation, as well as the presence of localized tenderness in radial head, ulna and epicondylehemorrhoids, and examining the presence of ecchymosis and hematoma in the articular region by theexpert Emergency medicine is done, the results of the examinations are recorded in the questionnaireform. Then, the standard geometry of the elbow joint is requested and the results are analyzed separatelyby the two radiologists. After collecting and entering the data, SPSS software version 18 was analyzed.Findings: In this study, 85 patients (74.2%) were male and 36 female patients (29.8%) were referred tothe emergency department of Imam Khomeini hospital in Sari, from 121 patients with blunt elbowtrauma. The highest frequency was over the age of 50 years (25.6%).The most frequent causes of injuries were pedestrians (57.9%). Extension limitations in the elbow jointwere the most frequent among the patients, and the lowest observed sign was also in localized sensitivityin the epicondyle site of the bone arm. The greatest fracture was observed in the radius of the elbow joint,which was seen in 19.8% of the subjects. The least fracture in the proximal bone marrow was observed in5% of the patients referred. The specificity and sensitivity values for extensions of 49.1 and 69.7 werecalculated. Conclusion: We conclude that patients with a recent injury to the elbow who are not able to extend theelbow joint predict with specificity and high sensitivity of the fracture of the elbow bones and alsoincrease the clinical suspicion of the doctor without the use of Para clinic (radiography) In contrast toother examinations, such as hematoma and ecchymosis, there is less diagnostic value to predict thefracture of the elbow joint bones.

Keywords:

Radiography , clinical findings , elbow joint