ABSTRACT
Medico-legal documentation of alleged exposure to falanga torture warrants a high diagnostic accuracy of the applied clinical tests. The objective of this study was to establish data on the validity of palpatory examination of the footpads and the plantar fascia and to assess the distribution of observations among selected cases and non-cases in a small study sample. Calculated estimates of sensitivity and specificity of the individual diagnostic tests are reported and, in general, did not meet the authority-based criteria of an 80% cut-off point. The observed total number of true tests in this study was 65 %. It is concluded that future studies of the reliability of clinical examination and assessment of the variability of observations among unselected cases and non-cases should be conducted in a larger cross-sectional study population.
Subject(s)
Heel/physiopathology , Palpation/methods , Torture , Wounds, Nonpenetrating/diagnosis , Case-Control Studies , Confidence Intervals , Fasciitis, Plantar/diagnosis , Fasciitis, Plantar/etiology , Forensic Medicine/methods , Humans , Male , Observer Variation , Odds Ratio , Physical Examination/methods , Pilot Projects , Predictive Value of Tests , Torture/classification , Wounds, Nonpenetrating/etiologyABSTRACT
The long-term consequences of falanga are probably the best described consequences of exposure to specific forms of physical torture. Theories about casual lesions in the peripheral tissues of the feet have been put forward based on clinical observations along with international guidelines for the clinical assessment, but still knowledge is needed in several areas. A review of the literature on falanga is presented, mainly focusing on the clinical aspects and possible lesions caused by this specific form of torture that may influence the overall management of the condition. Finally, the article closes with a call for future research, which is needed in order to advance a knowledge-based development of the applied clinical practice.
