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Journal of Trauma and Injury 2014;27(2):13-19.
Factors Associated with Radiologic Tests in Patients with Radial Head Subluxation
Ikwan Chang, Do Kyun Kim, So Young Park, Dongbum Suh, Jae Yun Jung, Young Ho Kwak
Department of Emergency Medicine, Seoul National University College of Medicine, Korea. birdbeak@naver.com
요골두아탈구 환자에서 방사선 검사 시행과 연관된 인자 분석
장익완, 김도균, 박소영, 서동범, 정재윤, 곽영호
서울대학교 의과대학 응급의학교실
Received: 14 January 2014   • Revised: 10 April 2014   • Accepted: 10 June 2014
Abstract
PURPOSE
In general, X-ray examinations are not recommended for radial head subluxation (pulled elbow) patients. The purpose of this study was to determine the frequency of X-ray examinations and to investigate the factors associated with the decision to perform an X-ray examination on a patient with a pulled elbow.
METHODS
Patients who visited the pediatric emergency department (ED) of one tertiary hospital from January 1, 2011, to December 31, 2012, with a diagnosis of radial head subluxation at discharge were enrolled in this study. Through retrospective chart reviews, factors that could have influenced the decision to perform an X-ray examination and their statistical relevance were analyzed.
RESULTS
A total 308 patients were enrolled, and 101 patients (32.8%) underwent X-ray examinations. Among the 252 patients with a typical pulled elbow, 65 underwent X-ray examination. This result showed statistical significance compared to atypical pull-elbow group (25.8% vs. 64.3%, p<0.001). Factors associated with the decision to perform an X-ray examination were analyzed using the Chi-square test and the Fisher's exact test. The mechanism of injury and consultation with an orthopedic surgeon (p=0.001) showed statistical significance. In the multivariable logistic regression, the odds ratio (OR) for the injury mechanism was 4.7 (95% CI: 1.8~8.8, p<0.001) and that for consultation with an orthopedic surgeon was 8.0 (95% CI: 1.6~40.7, p=0.004).
CONCLUSION
One third of patients with a pulled elbow underwent X-ray examination, and patients with an atypical mechanism of injury underwent more frequent X-ray examinations than did patients with a typical mechanism of injury. The factors that could have influenced the decision to perform an X-ray examination were mechanism of injury and consultation with an orthopedic surgeon.
Key Words: Radius; X-ray; Child


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