Effectiveness of Ultrasonography in Detecting Metacarpal Fractures at Al-Nafees Medical Hospital, Islamabad: A Cross-Sectional Study

Abstract

Objective: To compare the effectiveness of ultrasound and direct radiography on the detection and
management of metacarpal fractures.
Study Design: A cross-sectional Study.
Place and Duration of Study: This study was conducted at the Department of Emergency, Al-Nafees Medical
Hospital, Islamabad, Pakistan from August 2022 to August 2023.
Methods: The study was conducted on 60 patients suspected of metacarpal fracture. All patients underwent
point-of-care ultrasonography and direct radiography. Data, including swelling, point tenderness, crepitus,
ecchymosis, deformity, neurovascular injury, or range of motion, was recorded.
Results: The results showed that direct radiograph detected fractures in 32 (53.3%) patients, while point-ofcare
ultrasonography detected fractures in 34 (56.6%) patients. Compared to direct radiograph, the sensitivity,
specificity, positive predictive value, and negative predictive value of point of care ultrasonography for fracture
detection were 92%, 87%, 89% and 90% respectively. point-of-care ultrasonography detected all adjacent bone
fractures. The 5th metacarpal neck was the most common site of fracture. Compared to direct radiograph, the
sensitivity, specificity, positive predictive value, and negative predictive value of point of care ultrasonography
for fracture localization were 92%, 87%, 89% and 89% respectively. With point-of-care ultrasonography,
angulation was detected in 41 (68.3%) patients and step-off in 14 (24%) patients. With direct radiograph,
angulation was detected in 40 (66.6%) patients and step off in 13 (21.6%) patients. Point-of-care
ultrasonography detected intramuscular hematoma in 9 (15%) patients. Based on the evaluation of physicians
who performed direct radiograph and point-of-care ultrasonography, 17 (28.3%) patients required an elastic
bandage, and 2 (3.3%) required surgery.
Conclusion: Point-of-care ultrasound is an effective tool for diagnosing metacarpal fractures and can be used as
an alternative to radiography.

How to cite this: Asim A, Abbasi SH, Sarfraz M, Bashir MA, Kanwal S, Imtiaz H. Effectiveness of Ultrasonography in Detecting Metacarpal Fractures at Al-Nafees Medical Hospital, Islamabad: A Cross-Sectional Study. Life and Science. 2025; 6(3): 394-398. doi: http://doi.org/10.37185/LnS.1.1.556