Clinical Pearl Wednesday #125

X Ray Medical Broken Arm Doctor  - nickwarrilow / Pixabay

Have a patient with a suspected fracture presenting to your office or are you seeing them via telemedicine? Here is a fun, quick, and free way to help with your clinical decision making process in determining the chances of a fracture without doing an x-ray:

The tissue surrounding the bones contain a lot of nerve fibers. The reason why fractures hurt so bad is because this tissue is often damaged during the injury. High frequency vibrations often will irritate this tissue more so than movement associated with a sprain/strain type injury. So, pull out your phone or have the patient pull out their phone and put it on vibrate. Then place the phone gently on top of the area of concern. If this elicits an unproportionable pain response, then the chances of the bone being broken are high and further workup is warranted!

As always, use your best clinical judgement.

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