سال انتشار: ۱۳۸۶

محل انتشار: دومین همایش سراسری طب اورژانس

تعداد صفحات: ۱

نویسنده(ها):

Gholamreza Hemmasi – Faculty Member of EM of TUMS

چکیده:

Acute ankleinjury aeramong the most frequent presentation complaints in emergency departments . most ankle injury patient undergo radiography, whereas onlyn asmallportion of them have significant fractures of avulsion fractures, rationalizing the use of ankle radiography may reduce ED waiting time,excessiveradiation foe patient ans directcosts of radiography for the health care system, steill et al developned clinical prediction rules (termed ottawa ankle relues) anddeclared thatby these rules the numberof ankle and midfoot radiographies needed reduces to 1/3with a sensitivityof 100%. This study isassesing the sensitivity and specificitry of these rules in our countrywhichhas never been done in IRAN .inthis prospectivecohort survey whichwas conducted in the ED of HAZRAT RASOOL MEDICAL COMPLEX, the study group consistedof 276consecutive patients aged 18years and older was presented with acute ankle and midfoot injuries in the EDduring fourmonths periodand met the given criteria. Radiography was performed in each patienr after clinical avaluation findings were recorded.
The study group compromised 151 men & 125 wemon. 91.7% ofpalienls has presented to thc ED in the first day of injury. The most frequenttypes of injury were sprain (41.3%) and soft tissue injury(27.5%), respecti vely the most frequnt mechanism of injury was inversion (41.3%) followed by cversion (26.87c).ln 199 cases the radiographic findings were nurmal. .thitysix ankle fracture were diagnosed (9.13%) which all of them met the eules’ criteria in another word. The rules didnil fail to predict any ankle fracture. Of 240 patients without any fracture,101 met the rules criteria and theremaining 139 didn’t meet. The decision rules had a sensitivity of 100% and a specificity of 58%,negative predictive value of 100% and pelsitive predictive value of 26% Application of the Ottawa arikle rule by emergency physicians resulted in100% sensitivity and would have reducedankleradiography requested by 13%.