Fracture sonography—review of literature and current recommendations

• Published in: Archives of orthopaedic and trauma surgery 2024-07, Vol.144 (7), p.3025-3043
• Main Authors: Ackermann, Ole, Fischer, Christian A., Grosser, Kay, Hauenstein, Christina, Kluge, Sebastian, Moritz, Jörg D., Berthold, Lars, Kaisenberg, Constantin v., Tesch, Christian
• Format: Article
• Language: English
• Subjects: Clinical trials; Medicine; Medicine & Public Health; Orthopaedic Surgery; Orthopedics; Ultrasonic imaging
• ISSN: 1434-3916; 0936-8051; 1434-3916
• DOI: 10.1007/s00402-024-05396-1

Over a span of more than two years, a collaborative expert group consisting of 9 professional societies has meticulously crafted the S2e guideline on fracture sonography. This publication encapsulates the essential insights pertaining to specific indications. A thorough and systematic literature search, covering the period from 2000 to March 2021, was conducted across PubMed, Google Scholar, and the Cochrane Database of Systematic Reviews, complemented by an evaluation of bibliographies. Inclusion criteria encompassed randomized controlled clinical trials, observational clinical trials, meta-analyses, and systematic reviews, while guidelines, conferences, reviews, case reports, and expert opinions were excluded. The SIGN grading system (1999–2012) was applied to assess evidence, and resultant SIGN tables were presented to the expert group. Specific recommendations for the application of fracture sonography were then derived through unanimous consensus after detailed discussions. Out of the initial pool of 520 literature sources, a meticulous screening and content assessment process yielded 182 sources (146 clinical studies and 36 meta-analyses and systematic reviews) for evaluation. The comprehensive analysis identified twenty-one indications that substantiate the judicious use of fracture sonography. Ultrasound emerges as a pragmatic and user-friendly diagnostic method, showcasing feasibility across a diverse range of indications.