• O Ackermann, S Sesia, T Berberich, P Liedgens, K Eckert, K Grosser, M Roessler, C Rülander, and T Vogel.
• Klinik für Orthopädie und Unfallchirurgie, Klinikum Duisburg, Zu den Rehwiesen 9, 47055 Duisburg. ole.ackermann@gmx.de [corrected]
• Unfallchirurg. 2010 Oct 1; 113 (10): 839-42, 844.

Aim Of The StudyThe exact determination of the extent of deformities in juvenile proximal humerus fractures is difficult with plain x-rays. The aim of this study was to find out whether proximal humerus fractures can be diagnosed and the extent of the deformity can be detected by ultrasonography.Patients And MethodsIn a prospective, multicentre trial children aged 0-12 years with suspected proximal humerus fractures were examined. Initially a standardized sonographic evaluation was performed and the extent and the direction of the deformity were determined. The recommended treatment was noted. Afterwards standard x-rays were taken and the results of both diagnostic procedures were compared.ResultsA total of 33 children were examined, 14 male and 19 female, with a mean age of 7.6 years. In the ultrasound examination 17 out of 18 proximal humerus fractures were detected. In comparison to x-ray diagnostics ultrasonography proved to have a sensitivity of 94% and a specificity of 100%. In 16 cases ultrasonography gave a better result than x-ray imaging and x-ray was better in 5 cases.ConclusionUltrasonography is suitable for detection and exclusion of fractures and better than x-ray diagnosis for evaluation of the type and direction of deformations of proximal humerus fractures.

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