Journal Information
Vol. 60. Issue 5.
Pages 454-458 (1 May 2004)
Share
Share
Download PDF
More article options
Vol. 60. Issue 5.
Pages 454-458 (1 May 2004)
Full text access
Los criterios de Ottawa para tobillo: valoración en un servicio de urgencias en México
The ottawa ankle rules: evaluation in a pediatric emergency setting in mexico
Visits
17680
C. Cuello-García
Corresponding author
carlos.cuello@itesm.mx

Departamento de Pediatría. Hospital San José-Tec de Monterrey. Escuela de Graduados en Medicina. Avda. Morones Prieto, 3000 Pte. Col. Doctores. 64710 Monterrey. México
, A. Ruiz-Flores, L. Ramos-Gómez, M.aE. Medina-López
Departamento de Pediatría y Servicio de Emergencias Pediátricas. Hospital San José-Tec de Monterrey. Escuela de Medicina, Instituto Tecnológico y de Estudios Superiores de Monterrey (ITESM), Monterrey. México
This item has received
Article information
Introducción

Las lesiones de tobillo son una causa frecuente de consulta en el departamento de emergencias. El objetivo del presente estudio es valorar el uso de los criterios de Ottawa para tobillo en nuestro país, para así reducir costes y tiempo de espera en la sala de urgencias

Pacientes y Método

Se aplicaron los criterios de Ottawa en pacientes de 0 a 18 años de edad con lesiones de tobillo. La medida principal fue la radiografía y/o la evolución clínica a través de contacto telefónico. La presencia de fractura significativa mediante uno de éstos, era el resultado adverso a evaluar

Resultados

Se incluyeron 111 pacientes con edades de 3 a 18 años, 15 % de los cuales presentaron fracturas de tobillo. La sensibilidad y el valor predictivo negativo de los criterios de tobillo de Ottawa fueron del 100 %. Aplicarlos hubiese disminuido un 5,4 % la realización de radiografías

Conclusiones

Se ratifica la sensibilidad y aplicabilidad de los criterios de Ottawa para tobillo en niños en Hispanoamérica, aunque con menor ahorro en el uso de radiografías que en otros países

Palabras clave:
Lesiones de tobillo
Trauma pediátrico
Criterios clínicos de Ottawa para tobillo
Introduction

Pediatric ankle injuries are a common complaint in the emergency setting. The objective of this study was to prospectively validate the Ottawa ankle rules (OAR) in children in Mexico. This could reduce costs and waiting times in the emergency room

Patients and Method

The authors applied the OAR to all patients aged 0 to 18 years old with an acute ankle injury. The main outcome measure was radiograph and/or clinical outcome determined through telephone contact. The presence of fracture was considered an adverse outcome

Results

One hundred and eleven patients, aged 3–18 years, were enrolled. The prevalence of fractures was 15 %. The sensitivity and negative predictive value of the OAR were 100 %. Use of the OAR would have reduced the radiography rate by 5.4 %

Conclusions

The sensitivity and applicability of the OAR in children in Latin-America are confirmed, although reduction in the use of radiography is lower than in other countries

Keywords:
Ankle injuries
Pediatric injuries
Ottawa ankle rules
Full text is only aviable in PDF
Bibliografía
[1.]
T. Vargish, W.R. Clarke, R.A. Young, A. Jensen.
The ankle injury: Indications for the selective use of x-rays.
Injury, 14 (1983), pp. 507-512
[2.]
I.G. Stiell, G.H. Greenberg, R.D. McKnight, R.C. Nair, I. McDowell, J.R. Worthington.
A study to develop clinical decision rules for the use of radiography in acute ankle injuries.
Ann Emerg Med, 21 (1992), pp. 384-390
[3.]
I.G. Stiell, G.H. Greenberg, G.A. Wells, R.D. McKnight, A.A. Cwinn, T. Cacciotti, et al.
Derivation of a decision rule for the use of radiography in acute knee injuries.
Ann Emerg Med, 26 (1995), pp. 405-413
[4.]
I.G. Stiell, G.H. Greenberg, R.D. McKnight, R.C. Nair, I. McDowell, M. Reardon, et al.
Decision rules for the use of radiography in acute ankle injuries. Refinement and prospective validation.
Jama, 269 (1993), pp. 1127-1132
[5.]
I.G. Stiell, R.D. McKnight, G.H. Greenberg, I. McDowell, R.C. Nair, G.A. Wells, et al.
Implementation of the Ottawa ankle rules.
Jama, 271 (1994), pp. 827-832
[6.]
V.T. Chande.
Decision rules for roentgenography of children with acute ankle injuries.
Arch Pediatr Adolesc Med, 149 (1995), pp. 255-258
[7.]
K.L. McBride.
Validation of the Ottawa ankle rules. Experience at a community hospital.
Can Fam Physician, 43 (1997), pp. 459-465
[8.]
A.C. Plint, B. Bulloch, M.H. Osmond, I. Stiell, H. Dunlap, M. Reed, et al.
Validation of the Ottawa ankle rules in children with ankle injuries.
Acad Emerg Med, 6 (1999), pp. 1005-1009
[9.]
C. Libetta, D. Burke, P. Brennan, J. Yassa.
Validation of the Ottawa ankle rules in children.
J Accid Emerg Med, 16 (1999), pp. 342-344
[10.]
M.C. Yuen, F. Saunders.
Towards evidence based emergency medicine: Best BETs from the Manchester Royal Infirmary. The Ottawa ankle rules in children.
Emerg Med J, 18 (2001), pp. 466-467
[11.]
A. Karpas, H. Hennes, C.M. Walsh-Kelly.
Utilization of the Ottawa ankle rules by nurses in a pediatric emergency department.
Acad Emerg Med, 9 (2002), pp. 130-133
[12.]
Z.A. Mohammed, G.A. Baldwin.
Reappraisal of use of X-rays in childhood ankle and midfoot injuries.
Emergency Radiology, 9 (2002), pp. 88-92
[13.]
L.M. Bachmann, E. Kolb, M.T. Koller, J. Steurer, G. Ter Riet.
Accuracy of Ottawa ankle rules to exclude fractures of the ankle and mid-foot: Systematic review.
[14.]
B.G. Mines, T. Sutcliffe, T.P. Klassen.
Agreement in the interpretation of extremity radiographs of injured children and adolescents.
Acad Emerg Med, 2 (1995), pp. 826-830
Copyright © 2004. Asociación Española de Pediatría
Download PDF
Idiomas
Anales de Pediatría (English Edition)
Article options
Tools
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?