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Artigo em Inglês | MEDLINE | ID: mdl-38743847

RESUMO

INTRODUCTION: Pediatric ankle injuries are a common presentation in the emergency department (ED). A quarter of pediatric ankle fractures show no radiographic evidence of a fracture. Physicians often correlate non-weight bearing and tenderness with an occult fracture. We present this study to predict the probability of an occult fracture using radiographic soft-tissue swelling on initial ED radiographs. METHODS: This is a retrospective study at a Level 1 pediatric trauma center from 2021 to 22. Soft-tissue swelling between the lateral malleolus and skin was measured on radiographs, and weight-bearing status was documented. Statistical analysis was conducted using Stata software. DISCUSSION: The study period involved 32 patients with an occult fracture, with 8 (25%) diagnosed with a fracture on follow-up radiographs. The probability of an occult fracture was calculated as a function of the ankle swelling in millimeters (mm) using a computer-generated predictive model. False-negative and false-positive rates were plotted as a function of the degree of ankle swelling. CONCLUSION: Magnitude of ankle soft-tissue swelling as measured on initial ED radiographs is predictive of an occult fracture. Although weight-bearing status was not a sign of occult fracture, it improves the predictive accuracy of soft-tissue swelling.


Assuntos
Fraturas do Tornozelo , Edema , Fraturas Fechadas , Radiografia , Humanos , Fraturas do Tornozelo/diagnóstico por imagem , Estudos Retrospectivos , Masculino , Feminino , Criança , Edema/diagnóstico por imagem , Fraturas Fechadas/diagnóstico por imagem , Adolescente , Serviço Hospitalar de Emergência , Suporte de Carga , Probabilidade , Pré-Escolar , Valor Preditivo dos Testes
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