Shetty Test Challenges Ottawa Ankle Rules in Detecting Foot and Ankle Fractures: A Prospective Comparative Study.

Konstantinos G Makiev, Ioannis S Vasios, Anthimos Keskinis, Reichan Molla Moustafa, Georgios Petkidis, Athanasios Ververidis, Konstantinos Tilkeridis, Efthymios Iliopoulos
{"title":"Shetty Test Challenges Ottawa Ankle Rules in Detecting Foot and Ankle Fractures: A Prospective Comparative Study.","authors":"Konstantinos G Makiev, Ioannis S Vasios, Anthimos Keskinis, Reichan Molla Moustafa, Georgios Petkidis, Athanasios Ververidis, Konstantinos Tilkeridis, Efthymios Iliopoulos","doi":"10.30476/beat.2025.104975.1557","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>Ankle joint injuries are among the most common orthopedic injuries and are associated with significant healthcare costs. To reduce unnecessary radiographic screening, diagnostic tools such as the widely accepted Ottawa Ankle Rules (OARs) have been developed. However, the accuracy of OARs in excluding fractures remains uncertain. Recently, a new diagnostic test, the Shetty Test (ST), has been introduced. This prospective comparative study aimed to evaluate the diagnostic accuracy of the \"ST\" in comparison to the \"OARs\" for detecting ankle and foot fractures.</p><p><strong>Methods: </strong>A total of 112 consecutive adult patients (>18 years old) were included in the study. They were presented to the Emergency Department of a University Hospital in Alexandroupolis due to an ankle or foot injury. Data were collected over 6 months, from November 2022 to May 2023.</p><p><strong>Results: </strong>The sensitivity of the ST was 68.4%, specificity was 76.3%, positive predictive value (PPV) was 37.1%, and negative predictive value (NPV) was 92.2%. For the OARs, sensitivity was 94.7%, specificity was 15%, PPV was 18.5%, and NPV was 93.3%. When at least one of the tests was positive, the sensitivity and NPV increased to 100%.</p><p><strong>Conclusion: </strong>The ST was found to be reliable; however, it did not outperform the OARs in this study. Nevertheless, when used in conjunction, the two tests significantly improved sensitivity and the NPV. Due to its simplicity and reproducibility, the ST could be a valuable tool in daily clinical practice, particularly for non-orthopedic emergency department personnel.</p>","PeriodicalId":9333,"journal":{"name":"Bulletin of emergency and trauma","volume":"13 1","pages":"20-24"},"PeriodicalIF":0.0000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12036505/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Bulletin of emergency and trauma","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.30476/beat.2025.104975.1557","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

Abstract

Objectives: Ankle joint injuries are among the most common orthopedic injuries and are associated with significant healthcare costs. To reduce unnecessary radiographic screening, diagnostic tools such as the widely accepted Ottawa Ankle Rules (OARs) have been developed. However, the accuracy of OARs in excluding fractures remains uncertain. Recently, a new diagnostic test, the Shetty Test (ST), has been introduced. This prospective comparative study aimed to evaluate the diagnostic accuracy of the "ST" in comparison to the "OARs" for detecting ankle and foot fractures.

Methods: A total of 112 consecutive adult patients (>18 years old) were included in the study. They were presented to the Emergency Department of a University Hospital in Alexandroupolis due to an ankle or foot injury. Data were collected over 6 months, from November 2022 to May 2023.

Results: The sensitivity of the ST was 68.4%, specificity was 76.3%, positive predictive value (PPV) was 37.1%, and negative predictive value (NPV) was 92.2%. For the OARs, sensitivity was 94.7%, specificity was 15%, PPV was 18.5%, and NPV was 93.3%. When at least one of the tests was positive, the sensitivity and NPV increased to 100%.

Conclusion: The ST was found to be reliable; however, it did not outperform the OARs in this study. Nevertheless, when used in conjunction, the two tests significantly improved sensitivity and the NPV. Due to its simplicity and reproducibility, the ST could be a valuable tool in daily clinical practice, particularly for non-orthopedic emergency department personnel.

谢蒂测试挑战渥太华踝关节规则在检测足部和踝关节骨折:一项前瞻性比较研究。
目的:踝关节损伤是最常见的骨科损伤之一,与显著的医疗费用相关。为了减少不必要的x线检查,已经开发了诸如广泛接受的渥太华踝关节规则(OARs)之类的诊断工具。然而,桨叶在排除骨折方面的准确性仍然不确定。最近,引进了一种新的诊断测试,谢蒂测试(ST)。本前瞻性比较研究旨在评估“ST”与“OARs”在检测踝关节和足部骨折方面的诊断准确性。方法:共纳入112例连续成人患者(bb0 ~ 18岁)。由于脚踝或脚部受伤,他们被送到亚历山德鲁波利斯大学医院的急诊科。数据收集时间为6个月,从2022年11月到2023年5月。结果:ST敏感性为68.4%,特异性为76.3%,阳性预测值(PPV)为37.1%,阴性预测值(NPV)为92.2%。对于OARs,敏感性为94.7%,特异性为15%,PPV为18.5%,NPV为93.3%。当至少一项试验为阳性时,灵敏度和净现值增加到100%。结论:ST是可靠的;然而,在这项研究中,它并没有超过桨。然而,当结合使用时,这两个测试显着提高了灵敏度和NPV。由于其简单和可重复性,ST在日常临床实践中可能是一种有价值的工具,特别是对于非骨科急诊科人员。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
自引率
0.00%
发文量
49
审稿时长
12 weeks
期刊介绍: BEAT: Bulletin of Emergency And Trauma is an international, peer-reviewed, quarterly journal coping with original research contributing to the field of emergency medicine and trauma. BEAT is the official journal of the Trauma Research Center (TRC) of Shiraz University of Medical Sciences (SUMS), Hungarian Trauma Society (HTS) and Lusitanian Association for Trauma and Emergency Surgery (ALTEC/LATES) aiming to be a publication of international repute that serves as a medium for dissemination and exchange of scientific knowledge in the emergency medicine and trauma. The aim of BEAT is to publish original research focusing on practicing and training of emergency medicine and trauma to publish peer-reviewed articles of current international interest in the form of original articles, brief communications, reviews, case reports, clinical images, and letters.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信