The Value of Point of Care Ultrasound for Detecting Nail Bed Injury in Emergency Department

• Published in: The American journal of emergency medicine 2016
• Main Authors: Gungor, Faruk, Akyol, Kamil Can, Eken, Cenker, Kesapli, Mustafa, Beydilli, Inan, Akcimen, Mehmet
• Format: Article
• Language: English
• Subjects: Emergency
• ISSN: 0735-6757
• DOI: 10.1016/j.ajem.2016.06.067

Abstract Objective The aim of this study is to detect the value of point of care ultrasound (POCUS) for diagnosing a nail bed injury and fracture of distal phalanx in patients presenting with distal finger trauma to the emergency department. Methods Patients, 18–65 years old, presenting with a blunt trauma of distal finger and diagnosed with subungual hematoma were eligible for the study. Subungual hematoma extending over more than 50%, fracture of distal phalanx and disruption of periungual tissue or nail integrity were accepted as the indications for nail bed inspection. All the study patients underwent POCUS to detect the existence of a distal phalanx fracture or nail bed injury. X-ray was also obtained from all the patients. Results Nail bed was visualized in forty-five patients. Squeezing and crush injury were the most reported trauma mechanism in study patients (66.7%). The sensitivity and specificity of POCUS in detecting nail bed injury was 93.4% (95% CI: 80% to 99%) and 100% (95% CI: 74% to 100%), respectively. The sensitivity was 100% (95% CI: 79% to 100%) and specificity was 98.4% (95% CI: 91% to 100%) for distal phalanx fracture. Conclusion Point of care ultrasound is a promising tool in detecting the nail bed injury and distal phalanx fractures in patients presented with distal finger trauma. Further studies with bigger sample size are needed to reveal the diagnostic ability of POCUS before using it regularly in the emergency department.