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J Athl Train. 2009 May-Jun;44(3):272-4. doi: 10.4085/1062-6050-44.3.272.

The use of a tuning fork and stethoscope to identify fractures.

Author information

1
Radford University, Radford, VA, USA. mbmoore@radford.edu

Abstract

CONTEXT:

Nonradiographic tests to identify fractures rely on a patient's report of increased pain at the site of injury. These tests can be misleading and produce false-positive or false-negative results because of differences in pain tolerance. A painless technique using a tuning fork and stethoscope to detect fractures has undergone limited review in the athletic training literature.

OBJECTIVE:

To determine if the use of a 128-Hz vibrating tuning fork and stethoscope were effective in identifying fractures.

DESIGN:

Cross-sectional study.

SETTING:

University athletic training room or local orthopaedic center when fractures were suspected.

PATIENTS OR OTHER PARTICIPANTS:

A total of 37 patients (19 males, 18 females) volunteered.

MAIN OUTCOME MEASURE(S):

A diminished or absent sound arising from the injured bone as compared with the uninjured bone represented a positive sign for a fracture. Radiographs interpreted by the attending orthopaedic physician provided the standard for comparison of diagnostic findings.

RESULTS:

Sensitivity was 0.83 (10:12), specificity was 0.80 (20:25), positive likelihood ratio was 4.2, negative likelihood ratio was 0.21, and diagnostic accuracy was 81% (30:37).

CONCLUSIONS:

The tuning fork and stethoscope technique was an effective screening method for a variety of fractures.

KEYWORDS:

assessment; auscultation; false-negative results; false-positive results

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