Document Type : Original Article
Authors
- Konstantinos Georgios Makiev
- Ioannis Spyridon Vasios
- Anthimos Keskinis
- Reichan Molla Moustafa
- Georgios Petkidis
- Konstantinos Tilkeridis
- Athanasios Ververidis
- Efthymios Iliopoulos
Academic Department of Orthopaedics and Traumatology, University General Hospital of Alexandroupolis
Abstract
Objective: Orthopedic injuries involving the ankle joint are very common and incur high costs. To reduce unnecessary radiographic screening, diagnostic tools have been developed, such as the widely accepted Ottawa Ankle Rules (OARs), whose accuracy in excluding fractures remains uncertain. A new diagnostic test, the Shetty Test (ST), has been introduced recently. This prospective comparative study aims to evaluate the diagnostic accuracy of the "ST" in comparison to the "OARs" in screening for ankle and foot fractures.
Patients and Methods: A total of 112 consecutive adult patients (>18 years old) were included in the study, who presented in the Emergency Department of a University Hospital of Alexandroupolis due to an ankle or foot injury. Data were collected over a six-month period, from November 1, 2022, to May 1, 2023.
Results: The sensitivity of the ST was 68.4%, the specificity was 76.3%, the positive predictive value was 37.1% and the negative predictive value 92.2%. The sensitivity of OARs was 94.7%, the specificity was 15%, the positive predictive value was 18.5% and the negative predictive value was 93.3%. When at least one of the tests was positive, the sensitivity and negative predictive value increased to 100%.
Conclusion: The ST was found to be reliable, but did not perform better than the OARs in this study. It seems that when the two tests are used in conjunction, the sensitivity and the negative predictive value increase significantly. Moreover, due to its simplicity and reproducibility, it could be implemented in daily practice, especially by non-orthopedic emergency department personnel.
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