AI Article Synopsis
- Pediatric ankle injuries are common in emergency departments, with about 25% of fractures showing no visible evidence on X-rays; this study aims to predict occult fractures using soft-tissue swelling measurements.
- This retrospective study measured soft-tissue swelling on radiographs and documented weight-bearing status, analyzing 32 patients with occult fractures to develop a predictive model.
- The findings suggest that the amount of swelling is a good predictor of occult fractures, while weight-bearing status also enhances the accuracy of this prediction.
Article Abstract
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.
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Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11095954 | PMC |
| http://dx.doi.org/10.5435/JAAOSGlobal-D-23-00271 | DOI Listing |
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