The Comparison of Ottawa Ankle Rules and Shetty test performances in foot-ankle trauma patients visited to the emergency department |
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| Affiliation: | 1. Department of Emergency Medicine, Kartal Dr. Lütfi K?rdar City Hospital, Istanbul, Turkey;2. Department of Emergency Medicine, Istanbul Training and Research Hospital, Istanbul, Turkey;3. Department of Emergency Medicine, Istanbul Medipol Univesity, Faculty of Medicine Istanbul, Turkey;5. Department of Emergency Medicine, Taksim Training and Research Hospital, Istanbul, Turkey;1. Hand and Microvascular Surgery Unit, Department of Orthopedics, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Israel;2. TEREM Emergency Care Centers, Israel;3. Braun School of Public Health, Hadassah-Hebrew University, Jerusalem, Israel;1. Department of Orthopaedics and Traumatology, Medical University of Innsbruck, Innsbruck, Austria;2. Department of Medical Statistics, Informatics and Health Economics, Medical University of Innsbruck, Innsbruck, Austria;1. Department of Orthopaedics, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences (AIIMS), New Delhi, India;1. Department of Orthopedic Surgery, Kagawa Prefectural Central Hospital, 1-2-1, Asahi-machi, Takamatsu, Kagawa 760-8557, Japan;2. Scientific Research Works Peer Support Group (SRWS-PSG), Osaka, Japan;3. Department of Emergency Medical Center, Kagawa Prefectural Central Hospital, Kagawa, Japan;4. Department of Physical Therapy, Faculty of Health Care, Takasaki University of Health and Welfare, Gunma, Japan;5. Department of Orthopedic Surgery, Okayama Saiseikai General Hospital, Okayama, Japan;6. Department of Orthopedic Surgery, Mitoyo General Hospital, Kagawa, Japan;7. Department of Orthopedic Surgery, Tsuyama Chuo Hospital, Tsuyama, Japan;8. Department of Orthopaedic Surgery and Traumatology, Kawasaki Medical School General Medical Center, Okayama, Japan;9. Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama, Japan;1. Altnagelvin Area Hospital, Glenshane Road, Londonderry, BT47 6SB, Northern Ireland, United Kingdom;2. Northern Ireland Centre for Stratified Medicine, Ulster University, Derry, Co Londonderry, Northern Ireland, BT47 6SB, United Kingdom;1. Medisch Spectrum Twente, Koningstraat 1, Enschede, KZ 7512, The Netherlands;2. OLVG Hospital, Oosterpark 9, Amsterdam, AC 1091, The Netherlands;3. LUMC Leiden and OLVG Hospital, Oosterpark 9, Amsterdam, AC 1091, The Netherlands |
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| Abstract: | BackgroundThe Ottawa Ankle Rules (OARs) and Shetty test (ST), are assessment guidelines intended to minimize radiographs in patients with ankle trauma. The aim of this study is to determine and compare the effectiveness of OARs and ST in patients admitted to the emergency department (ED) with foot and ankle trauma.MethodsThis prospective cohort study was carried out in the ED of a tertiary care teaching hospital. OARs and ST were practiced by different doctors to patients, who were admitted with foot and ankle trauma. X-ray images were analyzed by a radiologist. Accuracy measures were covered such as sensitivity, specificity, positive predictive value, negative predictive value.ResultsThe study was completed a total of 207 patients, after achieving the inclusion and exclusion criteria. The mean age of the patients was 33.1±16.3, and 96 (46.4%) were female. For OARs, it was determined that as sensitivity 97.22%, specificity 48.89%, positive predictive value 50.36%, negative predictive value 97.06%, positive likelihood ratio 1.9 and negative likelihood ratio 0.06. If the OARs had been used, there would have been a 32.8% reduction in the ankle X-ray system. For the ST, it was determined that as sensitivity 51.39%, specificity 85.93%, positive predictive value 66.07%, negative predictive value 76.82%, positive likelihood ratio 3.65 and negative likelihood ratio 0.57.DiscussionThe OARs can be used as a screening tool, due to causing the high sensitivity in foot and ankle traumas. The ST was found to be inefficient in this study. In addition, the significant reduction in the number of X-rays with the use of OARs is another major result of the study. |
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