{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T21:58:59Z","timestamp":1779141539938,"version":"3.51.4"},"reference-count":0,"publisher":"Georg Thieme Verlag KG","issue":"03","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ultraschall in Med"],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2002Distal forearm fractures are the most common fractures in childhood and can be diagnosed with ultrasound. The aim of this study was to demonstrate the eligibility of Wrist SAFE for clinical use and the avoidance of X-ray application in children.<\/jats:p><jats:p>\n          Methods\u2002We enrolled patients from 0\u200a\u2013\u200a12 years with suspected distal forearm fractures. They were treated according to the Wrist SAFE algorithm, a detailed pathway for ultrasound fracture diagnosis, treatment decisions and control options. Additionally, 9 clinical predictors were tested. Depending on sonographic and clinical findings, patients were treated with functional movement, immobilization or surgery. Follow-up was conducted after 5 days and 3 months.<\/jats:p><jats:p>\n          Results\u200216 physicians (6 specialists, 10 assistants) at 5 study sites examined 498 (234 boys, 251 girls, 13 not specified) patients with ultrasound, age 8.4 (0\u200a\u2013\u200a12) years. 321 (64\u200a%) patients were diagnosed with a fracture, 5 (0.8\u200a%) with suspected fracture; X-rays were conducted in 58 cases (12\u200a%), 9 (1.8\u200a%) of them on day 1 and 49 (9.8\u200a%) on day 5; sonographic diagnosis was confirmed in 57 of 58 (98\u200a%) cases; in one case, the sonographic diagnosis of \u201ccontusion\u201d was revised to \u201cradius fracture\u201d. 381 patients (77\u200a%) underwent final follow-up after an average of 96 (62\u200a\u2013\u200a180) days. All patients were symptom-free at that time. Palpatory bone pain over the radius\/ulna and swelling were identified as clinical predictors. 81\u200a% of X-rays were avoided.<\/jats:p><jats:p>\n          Conclusion\u2002Wrist SAFE enables the safe diagnosis and therapy of distal forearm fractures in children. Findings can be reviewed safely, also enabling physicians in training to use the method. 81\u200a% of X-rays can be avoided, a figure that corresponds to 2.8 million X-rays in the G10 member states. After performing 100 examinations, physician have acquired the necessary sonography skills.<\/jats:p>","DOI":"10.1055\/a-0825-6284","type":"journal-article","created":{"date-parts":[[2019,2,5]],"date-time":"2019-02-05T18:56:17Z","timestamp":1549392977000},"page":"349-358","source":"Crossref","is-referenced-by-count":23,"title":["Sokrat II \u2013 An International, Prospective, Multicenter, Phase IV Diagnostic Trial to Evaluate the Efficacy of the Wrist SAFE Algorithm in Fracture Sonography of Distal Forearm Fractures in Children"],"prefix":"10.1055","volume":"40","author":[{"given":"Ole","family":"Ackermann","sequence":"additional","affiliation":[{"name":"Orthopedic Surgery, Ruhr-University Bochum, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Piotr","family":"Wojciechowski","sequence":"additional","affiliation":[{"name":"Surgery, Uniwersytet Jagiellonski Collegium Medicum Wydzial Lekarski, Krakow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Dzierzega","sequence":"additional","affiliation":[{"name":"Emergency Medicine, Uniwersytet Jagiellonski Collegium Medicum Wydzial Lekarski, Krakow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kay","family":"Grosser","sequence":"additional","affiliation":[{"name":"Pediatric surgery, HELIOS-Klinikum Erfurt, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ansgar","family":"Schmitz-Franken","sequence":"additional","affiliation":[{"name":"Orthopedic surgery, Rheintor-Klinik, Neuss, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henrik","family":"Rudolf","sequence":"additional","affiliation":[{"name":"Department for medical computer science, biometry and epidemiology, Ruhr-University Bochum, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kolja","family":"Eckert","sequence":"additional","affiliation":[{"name":"Pediatric surgery, Heinrich-Heine-Universit\u00e4t D\u00fcsseldorf Medizinische Fakult\u00e4t, D\u00fcsseldorf, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2019,2,5]]},"container-title":["Ultraschall in der Medizin - European Journal of Ultrasound"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-0825-6284.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,5,28]],"date-time":"2019-05-28T19:41:51Z","timestamp":1559072511000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-0825-6284"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,2,5]]},"references-count":0,"journal-issue":{"issue":"03","published-online":{"date-parts":[[2019,5,28]]},"published-print":{"date-parts":[[2019,6]]}},"URL":"https:\/\/doi.org\/10.1055\/a-0825-6284","relation":{},"ISSN":["0172-4614","1438-8782"],"issn-type":[{"value":"0172-4614","type":"print"},{"value":"1438-8782","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,2,5]]}}}