$using a tuning fork for fractures$ $using a tuning fork for fractures$

#USING A TUNING FORK FOR FRACTURES SERIES#

Sensitivity is 82% with a (-) predictive value of 13%. Again this technique a specificity of 67% but a (+) predictive value of 99%. UltrasoundĪ 1-MHz frequency ultrasound transducer at 2.0 w/cm 2 for 30 seconds over the region of the suspected stress fracture can be used to reproduce pain. The use of a vibrating tuning fork over the area of discomfort has been reported to have limited diagnostic value (specificity = 67%) and modest screening value (sensitivity = 75%). The vibration over the periosteum of a stressed bone has been shown to produce pain in the region of the stress fracture. The use of a 256 Hz tuning fork and therapeutic ultrasound function in a similar way for discerning the presence of a fracture. If a fracture is present, the reverberating force will produce the pain. With the ankle in neutral, the lower leg is stabilized and the clinician applies a firm, controlled, longitudinal force (bump) with the thenar eminence to the patient’s heel. The Bump test is done in a non-weight bearing position. Other techniques for stress fractures include the bump test, tuning fork, and therapeutic ultrasound. If this criteria is achieved, radiographs should be obtained and activity/weight bearing should be restricted. Interpretation of the BSI score is as follows: a score ≥ 4 and at least 1 examination finding. High risk structures include femoral neck, anterior tibia, medial malleolus, navicular, talus, proximal 2 nd and 5 th metatarsals, patella, and toe sesamoids. These include Risk Factors, Symptoms, and Examination elements. Nye et al (2016) developed an algorithm to improve diagnostic accuracy of suspected bone injuries.

$using a tuning fork for fractures$

Bone stress injuries (BSI) are the inability of a bone to withstand repetitive loading. Not all bone injuries are displaced fractures. A positive test is reproduction of pain along the shaft of the 5th metatarsal. The clinician grasps the metatarsal distal aspect of the 5th metatarsal and applies a longitudinal load. The metatarsal load test is used to evaluate the potential of this injury. This injury is known as a Jones fracture. Metatarsal Load TestĪnother bone commonly fractured is the 5 th metatarsal. Fortunately, radiographs have a specificity of 88% – making them a strong diagnostic tool. The high sensitivity tells us they are designed be a reliable screening tool to determine if a radiograph is needed. These data are displayed below:Īs per the statistical data, one can see from the low specificity, the Ottawa Rules are not intended to be diagnostic of a fracture. They have been validated for both adults and children. Both of these sets of rules have been studied extensively.

#USING A TUNING FORK FOR FRACTURES SERIES#

Interpretation is if ANY of the criteria are positive, a radiographic series is warranted. Further studies fine-tuned these “rules” to become the Ottawa Ankle and Ottawa Foot Rules. Equally impressive is the fact that using these “rules” would allow for a reduction of 36% of radiographs ordered. Using these rules, the sensitivity was 100% and specificity was 40%. What they found was that all 70 malleolar fracture identified in 689 ankle radiographs identified pain near the malleoli, were over 55 years of age, had local tenderness on the posterior edge or tip of the malleoli, or were unable to bear weight immediately/in the emergency room. They identified the clinical variables capable of predicting fractures and/or the need for radiographs. In 1992, Stiell et al conducted a pilot with 155 adults and a main study with 750 adults. However, there are clinical tests that can help you determine if a radiograph is really necessary. Unless you have x-ray eyes, you don’t have that immediate answer. That is often the first question asked about an ankle injury. News Orthopedic Clinical Tests iOrtho Admin JanuIs it broken?

$using a tuning fork for fractures$

Using a tuning fork for fractures