Bone Abstracts

Rationale and Hypothesis: Standard practice for differentiating fractures from sprains requires conventional radiographs. Up to 21% of wrist and ankle radiographs in children are negative at a local cost of over £100,000 per annum, approximately £12 million per annum across England and Wales. Our recent pilot study in adults confirmed that vibration analysis in injured patients causes no discomfort.

Objectives: To assess the ability of vibration analysis to differentiate sprains from fractures in children presenting to Emergency Departments following wrist or ankle trauma. To assess patient preference for radiographs or vibration.

Methodology: Prospective consent and recruitment of 100 children presenting to a local Emergency Department following wrist or ankle trauma. All were scanned using the vibration analysis technique before standard radiographs were obtained. Analysis of 50 wrist data sets has been completed using median frequency methods without knowledge of the gold-standard radiographic diagnosis. Analysis of the remaining participants has yet to be completed.

Results: Concerning fractures, 22/23 (95.7%) correctly identified. Concerning sprains, 18/27 (66.7%) were correctly identified. Therefore, vibration analysis would have reduced the number of unnecessary radiographs by 67% at a cost saving of £67,000 locally and roughly £8million across England and Wales per annum. However one patient would have been discharged with a fracture. The questionnaire results were as follows: preferred radiographs 13 (26%); preferred vibration 13 (26%); no preference 24 (48%).

Conclusion: Interim data analysis supports the hypothesis that vibration analysis can be used as an effective screening tool for wrist fractures before radiological exposure and warrants larger studies to explore sensitivity, specificity and further applications.

Disclosure: The authors declared no competing interests.