Publication:
Diagnostic accuracy of fresno-quebec rules and risk factors for an associated fracture in patients presenting to the emergency department with anterior shoulder dislocation: A retrospective study

dc.contributor.buuauthorDurak, Vahide Aslihan
dc.contributor.buuauthorDURAK, VAHİDE ASLIHAN
dc.contributor.buuauthorAtici, Teoman
dc.contributor.buuauthorATICI, TEOMAN
dc.contributor.departmentBursa Uludağ Üniversitesi/Tıp Fakültesi/Acil Tıp Anabilim Dalı.
dc.contributor.departmentBursa Uludağ Üniversitesi/Tıp Fakültesi/Ortopedi ve Travmatoloji Anabilim Dalı.
dc.contributor.orcid0000-0003-0836-7862
dc.contributor.orcid0000-0002-3396-3407
dc.contributor.researcheridAAE-9483-2021
dc.date.accessioned2024-06-27T12:50:39Z
dc.date.available2024-06-27T12:50:39Z
dc.date.issued2021-01-01
dc.description.abstractBACKGROUND: Anterior shoulder dislocation is the most common shoulder injury in patients presenting to the emergency department (ED). Up to 25% of these injuries are fracture-dislocations. In general, the standard approach is to obtain plain radiographs before and after reduction. Fresno-Quebec Rules (FQR) are described to identify the patients who require an x-ray before reduction to reduce radiation exposure and delays in treatment. We aimed to evaluate the efficacy of clinical predictors used in the Fresno-Quebec algorithm for detecting a shoulder fracture-dislocation.METHODS: Records of patients who presented to the Emergency Department with presumed shoulder dislocation were retrieved and retrospectively analyzed according to 'Fresno-Quebec Rule (FQR)'. Sensitivity, specificity, and predictive values of FQR for detecting associated injuries were calculated.RESULTS: Eighty-nine (65.9%) men and 46 (34.1%) women were included. The mean age of patients was 46 years (16-89). Ninety-nine (73.3%) of the cases had their shoulder dislocated for the first time, whereas 36 (26.7%) patients had a recurrent dislocation. Fifty percent of the patients (18 cases) with recurrent dislocation presented with an atraumatic episode. The remaining 18 patients with a history of recurrent dislocations had their shoulder dislocated as a result of trauma, and four (22%) of them had fracture-dislocation. Using the Fresno-Quebec rules yielded 100% specificity for the diagnosis of fracture-dislocation. The severity of the injury mechanism was not predictive in traumatic but recurrent dislocations. Only one of four patients with a fracture-dislocation in the traumatic recurrent dislocation group had high energy trauma.CONCLUSION: FQR has 100% sensitivity in detecting fracture-dislocations in patients admitted to ED with anterior shoulder dislocation. It utilizes simple parameters that are easy to use and recall. Using these rules, 30% of unnecessary radiographs can be avoided, saving time and money and reducing radiation exposure in anterior dislocations.
dc.identifier.doi10.14744/tjtes.2020.29402
dc.identifier.endpage121
dc.identifier.issn1306-696X
dc.identifier.issue1
dc.identifier.startpage115
dc.identifier.urihttps://doi.org/10.14744/tjtes.2020.29402
dc.identifier.urihttps://hdl.handle.net/11452/42532
dc.identifier.volume27
dc.identifier.wos000604992400020
dc.indexed.wosWOS.SCI
dc.language.isoen
dc.publisherTurkish Assoc Trauma Emergency Surgery
dc.relation.journalUlusal Travma Ve Acil Cerrahi Dergisi-turkish Journal Of Trauma & Emergency Surgery
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.subjectRadiographs
dc.subjectDangerous mechanism of injury
dc.subjectFresno-quebec
dc.subjectHumerus fracture reduction
dc.subjectShoulder dislocation
dc.subjectScience & technology
dc.subjectLife sciences & biomedicine
dc.subjectEmergency medicine
dc.subjectEmergency medicine
dc.titleDiagnostic accuracy of fresno-quebec rules and risk factors for an associated fracture in patients presenting to the emergency department with anterior shoulder dislocation: A retrospective study
dc.typeArticle
dspace.entity.typePublication
relation.isAuthorOfPublicationfef584c2-9e17-4aaf-a681-04eda6a3ea30
relation.isAuthorOfPublicationac435e38-cf12-4daf-9c63-b2173adafd98
relation.isAuthorOfPublication.latestForDiscoveryfef584c2-9e17-4aaf-a681-04eda6a3ea30

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