The Use of a Tuning Fork and Stethoscope to Identify Fractures

Abstract

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.