Medical Journal of the Islamic Republic Of Iran
مجله پزشکی جمهوری اسلامی ایران
Med J Islam Repub Iran
Medical Sciences
http://mjiri.iums.ac.ir
2
journal2
1016-1430
2251-6840
8
10.18869/mjiri
14
8888
13
en
jalali
1395
10
1
gregorian
2017
1
1
31
1
online
1
fulltext
en
Does the normal four steps weight-bearing rule predict the need for radiography in cases of blunt ankle trauma?
Trauma Surgery
Trauma Surgery
Brief Communication
Brief Communication
<p><strong>Background: </strong>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.<br>
<strong> Methods:</strong> 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.<br>
<strong> Results:</strong> 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.<br>
<strong> Conclusion: </strong>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.<br>
<br>
</p>
Ankle injury, Decision rules, Ottawa Ankle Rules, Four Steps Weight Bearing Rule
189
191
http://mjiri.iums.ac.ir/browse.php?a_code=A-10-644-1&slc_lang=en&sid=1
Hassan
Amiri
hasanamiri48@yahoo.com
200319475328460033284
200319475328460033284
No
Emergency Medicine Management Research Center, Iran University of Medical Sciences, Tehran, Iran. Tehran, Iran.
Samad
Shams Vahdati
sshamsv@yahoo.com
200319475328460033285
200319475328460033285
No
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.
Mehdi
Gharehkhani
mehdigharehkhani@yahoo.com
200319475328460033286
200319475328460033286
No
Tabriz International hospital, Tabriz, Iran.
Radin
Maheronnaghsh
radinmaheronnaghsh@gmail.com
200319475328460033287
200319475328460033287
No
Tehran University of Medical Sciences, Tehran, Iran.
Hamid
Shokoohi
hshokoohi@gmail.com
200319475328460033288
200319475328460033288
No
George Washington University Medical Center, Washington, DC, USA.
Vafa
Rahimi-Movaghar
v_rahimi@sina.tums.ac.ir
200319475328460033289
200319475328460033289
Yes
Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.