Ankle torque-related fractures and its echo-fast diagnosis protocol.
Ankle torque is the most frequent injury mechanism encountered in traumatology. It usually develops as an ankle sprain, and often produces an ankle fracture. Signs and symptoms are very unspecific on the differential diagnosis, and conventional radiographs must be obtained to confirm it. This study...
| Publicado en: | European Journal of Trauma & Emergency Surgery Vol. 46; no. 4; pp. 801 - 806 |
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| Autores principales: | , , , , |
| Formato: | diagnostic images research tables/charts Journal Article |
| Publicado: |
Springer Nature
2020
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=148387484&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 148387484 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 18639933 3C05 jtl: European Journal of Trauma & Emergency Surgery issn: 18639933 maglogo: N pubinfo: dt: 2020 vid: 46 iid: 4 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 148387484 144059484 148387484 148387484 10.1007/s00068-018-01069-y 148387484 ppf: 801 ppct: 5 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Ankle torque-related fractures and its echo-fast diagnosis protocol. aug: au: Ferràs-Tarragó, Joan Antequera-Cano, Juan Manuel Català-de-las-Marinas, Juan Jordà-Gómez, Pablo Aroca-Navarro, Jose Enrique affil: Orthopedic Surgery and Traumatology Department, La Fe Hospital, Valencia, Spain sug: subj: Ankle Fractures Diagnosis Ankle Fractures Radiography Torque Human Female Male Prospective Studies Fibula Fractures Diagnosis Tibial Fractures Diagnosis Diagnosis, Differential Chi Square Test Sensitivity and Specificity Predictive Value of Tests Ankle Sprain Descriptive Statistics Female Male ab: Ankle torque is the most frequent injury mechanism encountered in traumatology. It usually develops as an ankle sprain, and often produces an ankle fracture. Signs and symptoms are very unspecific on the differential diagnosis, and conventional radiographs must be obtained to confirm it. This study compares ultrasound and standard X-ray images values found in ankle sprain-related fracture diagnoses. A 3-month prospective study was carried out on 52 patients with ankle torque. First, an ultrasound diagnosis was made by the first researcher at their arrival to the emergency department, usually consisting of a longitudinal section of the fibula, tibia, and V metatarsal. Then, a blinded independent investigator carried out the usual diagnosis protocol using traditional radiographs. When the required number was obtained, a third independent investigator evaluated the results. A Chi-squared test was used to contrast the outcomes between sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) comparing a non-inferiority hypothesis of our protocol against standard X-ray images screening. Echography showed to be at least as good as standard radiographs on the screening of ankle torque-related fractures (p = 0.02). In our series of patients, nearly 8% of fractures are misdiagnosed with plain radiographies, which concurs with the lower limit found in the bibliography. All the false negatives on radiographs were true positives in the first ultrasound assessment. The average time for the ultrasound protocol was 42 s. An ultrasound is at least as effective as conventional X-ray images when used in diagnosing ankle sprain-related fractures, regardless of age or sex and could in fact be better. The use of echography could reduce the number of radiographies performed when diagnosing these kinds of fractures, thereby reducing the amount of radiation exposure and expediting the diagnostic process as well as the "in situ diagnosis". Level of clinical evidence 2 [prospective cohort (N > 30 patients) study]. pubtype: Academic Journal doctype: diagnostic images research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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