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Short Article

Radiographic assessment of acute ankle injuries - Tips from Other Journals

Radiographic assessment of acute ankle injuries is performed to hinder clinically significant fractures. Significant fractures come to one's mind in less than 15 percent of patients presenting to pinch departments with acute ankle injuries. Despite this grave percentage, the majority of patients with ankle injuries are referr for radiographic examination. Stiell and associates manner of lifeed a prospective study to identify predictors of clinically significant fractures in patients with acute ankle injuries.

The consideration included 750 adult patients with dull ankle injuries. Data were recorded on staff emergency department physicians before radiographic examination. A total of 689 ankle series were performed. Seventy significant malleolar fractures and 32 significant midfoot fractures were found

The authors determined that a radiographic series of the ankle was simply necessary in patients who had pain near the malleoli and had the same or more of the following factors: age above 55 years, localized bone tendernes of the posterior brim or tip of either malleolus, or inability to bear weight the pair immediately after injury and in the crisis department. This clinical decision empire was 100 percent sensitive and 401 percent specific for detecting malleolar fracture and would have reduc the number of ankle radiographic series ordered by way of 36.0 percent. Similarly, a radiographic series of the paw was only necessary in patients with pain in the midfoot and bone tendernes at the base of the fifth metatarsal, the cuboid or the navicular. Using these sum of two units clinical guidelines, none of the 102 significant fractures would have been missed.

The authors believe that these decision behaviors may reduce the number of radiographs ordered in patients presenting to the unforeseen occasion department with ankle injuries. (Annals of urgency Medicine, April 1992, vol. 21 p 384)