

Although only 39% of patients presenting to the emergency department with wrist trauma have sustained a fracture, the majority of patients are routinely referred back for radiography. For this reason, the Caradeniz wrist rules were developed in order to decrease the number of x-rays in suspected distal radius, distal ulna and carpal bone fractures within 24 hours after acute wrist traumas.
According to Karaca et al. (2016), the Caradeniz wrist rules have a sensitivity of 100% and a low specificity of 6.6 % in the detection of wrist fractures. These results have not been externally validated yet, which is why we give the rule a moderate clinical value to rule out wrist fractures.
The Decision Rule contains the following items. Due to their provocative nature, we propose the following order:
All of the 5 items are considered positive if pain is provoked. In the radioulnar drawer test, an increased amplitude of movement compared to the other side is considered as a positive test as well.
In case all 5 items are negative, a fracture of the radius, ulna, and carpal bones could be ruled out with 100% confidence in the study of Karaca et al. (2016).
If you want to screen for fractures in other body parts, check out the list below: