auscultatory percussion to evaluate suspected long bone fracture?

[Lifeguards For Life]

Stewart's surgical textbook mentions that, if one end of a fractured bone is percussed and a stethoscope applied to the other, the sound may fail to come through,Auscultatory percussion, the stethoscope being moved from one fragment to the other while percussion is made upon the first, will sometimes give a marked change in the sound as the line of fracture is crossed; but it is rarely significant, except in cases in which the diagnosis can be made by other means".2 I have been able to discover no further development in the interpretation or application of the
method.If auscultatory percussion is applied across two bony prominences
separated by a long bone, the sound heard through the stethoscope has a
characteristic "osteal" quality and is loud, high-pitched, and moderately
resonant. While to some extent this sound is modified by body structures
in the neighborhood of the examined area, the osteal quality always predominates and is directly attributable to the vibration of the bone in response to the percussion impact. Its loud volume is due to the excellent transmission of sound waves by the bony structure,


http://www.ejbjs.org/cgi/reprint/14/1/118.pdf

 

[zmedic]

When would you ever do this in the field? And if you did, what would you do if there was no auscultatory findings? Not splint the leg that the guy says hurts?

There are a lot of physical findings that people get all jazzed up about, like Homan's sign, but once you get into the positive and negative predictive values you might as well just guess or flip a coin.

Don't get me wrong, it's interesting. But I can see someone reading this and trying it, rather than starting the line, giving the pt pain meds, splinting the leg, doing their paperwork etc etc etc.

 

[Lifeguards For Life]

When would you ever do this in the field? And if you did, what would you do if there was no auscultatory findings? Not splint the leg that the guy says hurts?

There are a lot of physical findings that people get all jazzed up about, like Homan's sign, but once you get into the positive and negative predictive values you might as well just guess or flip a coin.

Don't get me wrong, it's interesting. But I can see someone reading this and trying it, rather than starting the line, giving the pt pain meds, splinting the leg, doing their paperwork etc etc etc.

lol Z, like many things i found this academically interesting, but like many things, it's application pretty useless

 

[reaper]

I just want to see the Pt's face as you tap on their fx'ed leg! That one should go over pretty good.

 

[MrBrown]

..... lets not