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Application of the Ottawa Protocol by Medical Students and Orthopedic Residents on Ankle Sprains at a Trauma Hospital / Aplicação do protocolo Ottawa por estudantes de medicina e residentes de ortopedia em entorses de tornozelo em um hospital de trauma
Lavrador Filho, José Marcos; Vogt, Paulo Henrique; Coelho, Alexandre Roberto Roman; Cho, Daniel Kyubin; da Silva, João Luiz Vieira; Padoani, Patrick Willian.
  • Lavrador Filho, José Marcos; Hospital do Trabalhador. Department of Orthopedics and Traumatology. Curitiba. BR
  • Vogt, Paulo Henrique; Hospital do Trabalhador. Department of Orthopedics and Traumatology. Curitiba. BR
  • Coelho, Alexandre Roberto Roman; Universidade Federal do Paraná. Department of Orthopedics and Traumatology. Curitiba. BR
  • Cho, Daniel Kyubin; Universidade Federal do Paraná. Department of Orthopedics and Traumatology. Curitiba. BR
  • da Silva, João Luiz Vieira; Universidade Federal do Paraná. Department of Orthopedics and Traumatology. Curitiba. BR
  • Padoani, Patrick Willian; Clínica de Fraturas e Ortopedia XV. Department of Orthopedics and Traumatology. Curitiba. BR
Rev. bras. ortop ; 55(5): 620-624, Sept.-Oct. 2020. tab
Article in English | LILACS | ID: biblio-1144222
ABSTRACT
Abstract Objective To verify the applicability and agreement of the Ottawa ankle rules applied by medical students and orthopedic residents in a tertiary trauma service thus validating the Ottawa protocol for use on Brazilian soil. Prospective This was a prospective study, conducted in a tertiary hospital, including all patients with acute torsial trauma of the tibiotarsal joint. The patients underwent ankle and/or foot radiographs, and the questionnaire with the Ottawa ankle rules was applied by academics and, subsequently, by residents. The radiographs were evaluated by on-call orthopedists and specialist in foot and ankle, and the expert opinion was considered the gold standard for analysis. Results Two hundred and sixty-three patients were evaluated, and, after application of the established inclusion criteria, 226 cases remained for evaluation. The sensitivity to detect lesions and negative predictive value (NPV) was 100%. The most sensitive test with higher NPV for both academics and residents was palpation of the lateral malleolus. The study presented potential for a reduction of 30% in the total number of tests requested. Conclusion The data showed applicability and agreement between academics and residents, which allows for the validation of the Ottawa protocol in emergency care in Brazil.
RESUMO
Resumo Objetivo Verificar a aplicabilidade e a concordância das regras do tornozelo de Ottawa aplicadas por estudantes de medicina e residentes de ortopedia em um serviço de trauma terciário, validando assim as regras de Ottawa para utilização em solo brasileiro. Método Estudo prospectivo, realizado em um hospital terciário, incluindo todos os pacientes com trauma torcional agudo da articulação tibiotársica. Os pacientes realizaram radiografias de tornozelo e/ou , tendo sido aplicado o questionário com as regras do tornozelo de Ottawa por acadêmicos e, na sequência, por residentes. As radiografias foram avaliadas por ortopedistas plantonistas e especialista em e tornozelo, sendo a opinião do especialista considerada padrão-ouro da análise. Resultados Foram avaliados 263 pacientes e, após aplicados os critérios de inclusão estabelecidos, restaram para a avaliação 226 casos. A sensibilidade para detectar lesões e o valor preditivo negativo (VPN) foi de 100%. O teste mais sensível e com maior VPN para ambos, acadêmicos e residentes, foi a palpação do maléolo lateral. O estudo apresentou potencial de redução de 30% no total de exames solicitados. Conclusão Os dados demostraram aplicabilidade e concordância entre acadêmicos e residentes, o que permite a validação do protocolo de Ottawa nos atendimentos de urgência e emergência no Brasil.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Wounds and Injuries / Prospective Studies / Surveys and Questionnaires / Ankle Injuries / Emergency Medical Services / Tertiary Care Centers / Fractures, Avulsion / Foot / Orthopedic Surgeons / Ankle Type of study: Observational study / Prognostic study / Risk factors Limits: Female / Humans / Male Language: English Journal: Rev. bras. ortop Journal subject: Orthopedics Year: 2020 Type: Article Affiliation country: Brazil Institution/Affiliation country: Clínica de Fraturas e Ortopedia XV/BR / Hospital do Trabalhador/BR / Universidade Federal do Paraná/BR

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Full text: Available Index: LILACS (Americas) Main subject: Wounds and Injuries / Prospective Studies / Surveys and Questionnaires / Ankle Injuries / Emergency Medical Services / Tertiary Care Centers / Fractures, Avulsion / Foot / Orthopedic Surgeons / Ankle Type of study: Observational study / Prognostic study / Risk factors Limits: Female / Humans / Male Language: English Journal: Rev. bras. ortop Journal subject: Orthopedics Year: 2020 Type: Article Affiliation country: Brazil Institution/Affiliation country: Clínica de Fraturas e Ortopedia XV/BR / Hospital do Trabalhador/BR / Universidade Federal do Paraná/BR