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#POCUS for distal radius fractures

February 22, 2017 1 Comment

Here is the next study presented by Dr Tom Jelic at the EDE 3 Journal Club. It was a multicentre study done in a few centres in Canada. Those centres were St. Paul’s Hospital in Vancouver (Dr Andrew Skinner), Foothills Hospital in Calgary (Dr Mark Bromley), Saint John Regional Hospital in Saint John (Dr Paul Atkinson), the Health Sciences Centre in St. John’s (Dr. Andrew Smith), and Health Sciences North in Sudbury. Click on the video below to see and hear Tom’s presentation. Click here for the full text version of the study.

 

We get a number of physicians kidding us that the EDE 2 instructors like to use POCUS for absolutely anything, implying that we would do so regardless of utility. But what they don’t see is the phase that we go through while sorting out novel uses to see if they actually have any utility. When an indication turns out to not be useful, we stop using it. It was like that for Colles fracture reductions. Many of us went through a phase where we thought “We’re good at reducing these fractures without ultrasound… Why would we need it?”. Then we only used it in selective cases and found it to be really quite useful. And then we started to use it routinely, because you can’t always predict when a reduction has gone well.

We do lots of Colles fracture reductions in Sudbury so, as a group, we’ve gotten pretty good at it over the years. But even at that, POCUS seems to increase the percentage of reductions where the post-reduction x-ray is literally perfect.

 

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  1. Lloyd Gordon says:

    I’m not sure why you wouldn’t want to look. I find the only purpose of the pre-reduction film is to delay the reduction until the block works. The post reduction film is for the Fracture Clinic.

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