فهرست نشریات علمی دسترسی آزاد ایران

Background and Objectives: The detection of pediatric extremity fractures on initial X-rays (XR) in emergency departments can be challenging, particularly in anatomically complex regions such as the ankle, wrist, knee, and elbow. The aim of this study is to determine the accuracy rate of XR compared to computed tomography (CT) in the identification of trauma-related extremity fractures in the pediatric population.    Methods: Patients aged 0-18 years were included in this retrospective study. Patients who were admitted to the emergency department due to extremity trauma between July 1, 2020 and March 31, 2023 and underwent XR and CT imaging were included. The sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio of XR in detecting fractures compared to CT were calculated.    Results: A total of 217 patients were included in the study. Fractures were detected in 57 patients (26%) on XR images and in 62 patients (29%) on CT images. The sensitivity, specificity, PPV and NPV of XR in detecting fracture compared to CT were 87%, 98%, 95%, and 95%, respectively (area under the curve [AUC]: 0.926, CI: 0.875-0.977). The sensitivity of XR was calculated to be below 60% in adjacent bone fractures, epiphyseal line fractures, and extension of the fracture into the joint space.    Conclusion: In the pediatric population, the sensitivity of XR is low in detecting epiphyseal line fractures, extension of the fracture into the joint space, and adjacent bone fractures.