امروز : سه شنبه 24 مهر ماه 1397
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پایگاه آموزشی مقابله با مصدومیت - تروما

Does the normal four steps weight-bearing rule predict the need for radiography in cases of blunt an

Does the normal four steps weight-bearing rule predict the need for radiography in cases of blunt ankle trauma?

Amiri H1, Shams Vahdati S2, Gharehkhani M3, Maheronnaghsh R4, Shokoohi H5, Rahimi-Movaghar V6.

Author information
1
Emergency Medicine Management Research Center, Iran University of Medical .Sciences, Tehran, Iran.
2
Instructor of Advanced Trauma Life Support, Local Director of PreHospital Trauma Life Support, Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
3
Tabriz International hospital, Tabriz, Iran.
4
Tehran University of Medical Sciences, Tehran, Iran.
5
George Washington University Medical Center, Washington, DC, USA.
6
Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Abstract
Background: Ankle injuries are one of the most common complaints of patients presenting to emergency departments (ED). The Ottawa ankle rules (OAR) was introduced to help physicians to decide who may require x-ray for blunt injuries. The present study aimed at validating the four steps weight-bearing rule of OAR as a sole criterion.

Methods: This prospective observational study was conducted on 214 patients with acute ankle injury who referred to 3 emergency departments over a 7-months period in 2008. Main outcome measures of this survey included the sensitivity, specificity, positive and negative predictive values, and the likelihood ratios (positive and negative) of the four steps weight-bearing rule.

Results: In this study, 34 fractures were found among the patients. The decision rule had a sensitivity of 0.88 and specificity of 0.61 in detecting all midfoot and ankle fractures. Application of this rule by emergency medicine residents resulted in a 47% reduction in the use of midfoot and ankle radiography.

Conclusion: Applying a four steps weight-bearing rule as a sole criterion to detect ankle fractures is not as accurate and sensitive as OAR. Solitary application of this rule may lead to an increasing number of missed fractures compared with OAR.

KEYWORDS:
Ankle injury; Decision rules; Four Steps Weight Bearing Rule; Ottawa Ankle Rules


https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5804468/pdf/mjiri-31-32.pdf


 نوشته شده توسط : Admin      در تاريخ : 1397/01/10        ساعت : 23:34     

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