Dear Editor,
X-ray scans are performed daily in medical facilities to diagnose bone fractures or detect foreign bodies. FUJIFILM (Tokyo, Japan) developed a portable X-ray system [Figure 1].
Figure 1.

CALNEO XairR developed by FUJIFILM (Tokyo, Japan). Left: The system carried by a physician, Right: The system in a helicopter. ① X-ray radiation apparatus, ② special cassette, ③ notebook-type personal computer
A 27-year-old Vietnam man was impaled by a metal bar while working in a mayonnaise factory [Figure 2]. After receiving an emergency call, the fire department and an ambulance were dispatched and dispatchment of a physician-staffed helicopter (PH) was requested.[1] When the staff of the PH, who brought a portable X-ray system, checked him at the rendezvous point, he showed the right median nerve paralysis. A right forearm X-ray, which was performed in the ambulance, showed fractures and the T like the end of the metal bar [Figure 3]. The images were simultaneously shared with orthopedicians in our hospital through a smartphone video transmission system.[2] The patient was transported to our hospital by the PH and underwent an emergency operation.
Figure 2.

The right forearm in the rendezvous zone. The right forearm was impaled by a metal bar
Figure 3.

Right forearm X-ray. The X-ray in the ambulance showed fracture and the T like end of the metal bar with which the patient's right forearm had been impaled
This is the first case report of fracture and foreign body in the right forearm that was evaluated at the scene by a portable X-ray system transported by a PH. Information from an X-ray study is help to diagnose and determine the severity of trauma or disease. In addition, the prehospital information from an X-ray study can provide time to think and prepare appropriate an operation plan for the surgical staff in the receiving hospital. This portable X-ray system may have the potential to change prehospital medical treatment and may lead to the development of new therapeutic strategies.
RESEARCH QUALITY AND ETHICS STATEMENT
The authors of this manuscript declare that this scientific work complies with reporting quality, formatting, and reproducibility guidelines set forth by the EQUATOR Network. The authors also attest that this clinical investigation was determined to require the Institutional Review Board/Ethics Committee review, and the corresponding protocol/approval number is (298). We also certify that we have not plagiarized the contents in this submission and have done a plagiarism check.
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
Acknowledgement
This manuscript received financial support from the Ministry of Education, Culture, Sports, Science, and Technology (MEXT)-Supported Program for the Strategic Research Foundation at Private Universities, 2015–2019 concerning (the constitution of a total research system for comprehensive disaster and medical management, corresponding to wide-scale disasters).
REFERENCES
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