Editorial
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Aug 18, 2017; 8(8): 606-611
Published online Aug 18, 2017. doi: 10.5312/wjo.v8.i8.606
Ultrasound diagnosis of fractures in mass casualty incidents
Fikri M Abu-Zidan
Fikri M Abu-Zidan, Department of Surgery, College of Medicine and Health Sciences, UAE University, Al-Ain 17666, United Arab Emirates
Author contributions: Abu-Zidan FM had the idea, critically read the literature, supplied the images, wrote the paper, and approved its final version.
Conflict-of-interest statement: None declared by the author.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Fikri M Abu-Zidan, MD, FACS, FRCS, PhD, Dip Applied Statistics, Professor, Consultant Surgeon (Acute Care Surgery and Disaster Medicine), Point-of-Care Sonographer, Statistical Consultant, Department of Surgery, College of Medicine and Health Sciences, UAE University, P.O. Box 15551, Al-Ain 17666, United Arab Emirates. fabuzidan@uaeu.ac.ae
Telephone: +971-3-7137579 Fax: +971-3-7672067
Received: January 29, 2017
Peer-review started: February 13, 2017
First decision: July 5, 2017
Revised: July 10, 2017
Accepted: July 21, 2017
Article in press: July 22, 2017
Published online: August 18, 2017
Abstract

The role of point-of-care ultrasound in mass casualty incidents (MCIs) is still evolving. Occasionally, hospitals can be destroyed by disasters resulting in large number of trauma patients. CAVEAT and FASTER ultrasound protocols, which are used in MCIs, included extremity ultrasound examination as part of them. The literature supports the use of ultrasound in diagnosing extremity fractures both in hospitals and MCIs. The most recent systematic review which was reported by Douma-den Hamer et al in 2016 showed that the pooled ultrasound sensitivity and specificity for detecting distal forearm fractures was 97% and 95% respectively. Nevertheless, majority of these studies were in children and they had very high heterogeneity. The portability, safety, repeatability, and cost-effectiveness of ultrasound are great advantages when treating multiply injured patients in MCIs. Its potential in managing fractures in MCIs needs to be further defined. The operator should master the technique, understand its limitations, and most importantly correlate the sonographic findings with the clinical ones to be useful. This editorial critically reviews the literature on this topic, describes its principles and techniques, and includes the author’s personal learned lessons so that trauma surgeons will be encouraged to use ultrasound to diagnose fractures in their own clinical practice.

Keywords: Fracture, Point-of-care ultrasound, Diagnosis, Mass casualty incidents

Core tip: The role of point-of-care ultrasound in mass casualty incidents (MCIs) resulting in large number of trauma patients is still evolving. Radiological workup of these patients is important. The portability, safety, repeatability, and cost-effectiveness of ultrasound are great advantages in these situations. Its potential in managing fractures in MCIs is not fully defined. Its role will depend on different factors. The operator should master the technique, understand its limitations, and most importantly correlate the sonographic findings with the clinical ones.