E5495. Evaluating Ultrasound Diagnostic Efficacy in Clavicle Fractures: A Comprehensive Systematic Review and Meta-Analysis
  1. Amir Hassankhani; University of Southern California
  2. Melika Amoukhteh; University of Southern California
  3. Ali Gholamrezanezhad; University of Southern California
The real-time, high-resolution imaging capabilities and point-of-care accessibility of ultrasound render it a valuable tool for diagnosing clavicle fractures. Increasing evidence substantiates its diagnostic accuracy in comparison to other imaging methods. This study seeks to meticulously assess the diagnostic utility of ultrasound in the detection of clavicle fractures.

Materials and Methods:
Employing established guidelines, a thorough systematic review and meta-analysis were conducted. A comprehensive literature search encompassing PubMed, Scopus, Web of Science, and Embase databases was performed up until March 10, 2023. Eligible studies reporting pertinent outcomes were included. Relevant data elements were extracted, and data analysis were carried out using STATA software version 17.0.

The meta-analysis, comprising seven studies, demonstrated notably high pooled sensitivity (0.94) and specificity (0.98) values for ultrasound in the diagnosis of clavicle fractures. Heterogeneity levels were generally low to moderate for sensitivity and high for specificity. Subgroup and meta-regression analyses unveiled that sensitivity was greater in pediatric studies, although their specificity was significantly lower (p = 0.01) compared to mixed or adult studies. Further subgroup analysis within the pediatric cohort revealed reduced heterogeneity regarding specificity. Fagan plot analysis exhibited favorable posttest probabilities for positive and negative results across diverse pretest probabilities. The likelihood ratio scatter matrix displayed a moderate to high test performance, serving both exclusionary and confirmatory purposes.

The collective body of literature consistently reinforces the credibility of ultrasound as a diagnostic modality for clavicle fractures. These findings emphasize that ultrasound can be effectively employed for accurate and timely diagnosis of clavicle fractures, particularly within the dynamic and time-critical context of the emergency department.