Citation

Matzek BA, Fivecoat PT, Ritz RB. Wilderness Environ. Med. 2014; 25(1): 99-102.

Affiliation

Department of Emergency Medicine, Carl R. Darnall Army Medical Center, Fort Hood, TX.

Copyright

(Copyright © 2014, Elsevier Publishing)

DOI

10.1016/j.wem.2013.09.011

PMID

24393702

Abstract

BACKGROUND: Fracture diagnosis in the austere environment where radiographic tests are not available can be a challenge. In the past, a diagnostic technique has been described using a tuning fork and stethoscope to assess decreased sound conduction in the fractured extremity. In this study, we evaluate the use of a cellular phone's vibrate function and a stethoscope to limit equipment carried by expeditionary practitioners.

OBJECTIVE: The purpose of this study was to evaluate the accuracy of fracture diagnosis using a cellular phone and stethoscope.

METHODS: This is a pilot study to assess the usefulness of the above technique before clinical implementation. In 3 cadavers, we created fractures of the humerus and femur. Twenty-seven emergency medicine residents and an attending physician performed the diagnostic technique.

RESULTS: Overall, the use of the cellular phone and stethoscope resulted in a sensitivity of 73% (95% confidence interval [CI]: 0.64 to 0.81) and a specificity of 83% (95% CI: 0.77 to 0.88), with a positive predicted value of 68% (95% CI: 0.59 to 0.77) and a negative predicted value of 86% (95% CI: 0.81 to 0.90). Positive likelihood ratio was 4.3, and negative likelihood ratio was 0.32.

CONCLUSIONS: The use of a cellular phone and stethoscope may be a useful tool for the diagnosis of fractures in the austere environment. However, further study is needed to validate these findings in the clinical environment.

Language: en