Aplicação do protocolo Ottawa por estudantes de medicina e residentes de ortopedia em entorses de tornozelo em um hospital de trauma

Filho, José Marcos Lavrador; Vogt, Paulo Henrique; Coelho, Alexandre Roberto Roman; Cho, Daniel Kyubin; Silva, João Luiz Vieira da; Padoani, Patrick Willian

doi:10.1055/s-0040-1702957

Cited by 4 publications

(2 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“… 7 The negative predictive value is also 100%, meaning that the use of the protocol has proved useful in excluding the diagnosis of fractures. 11 …”

Section: Introductionmentioning

confidence: 99%

Implementation of Ottawa Ankle Rules in University Hospital Emergency Room: Pilot Study

SCHIPER,

RODRIGUES,

REIS

et al. 2023

Acta ortop. bras.

View full text Add to dashboard Cite

Ankle injuries are the most common musculoskeletal injuries in emergency rooms and are associated with a great social and economic impact. The need to request additional tests for ankle sprains is based on suspicion of fracture. The Ottawa Ankle Rules (OAR) establish criteria for ordering radiographs to avoid performing unnecessary examinations. Objective: To evaluate the implementation of the Ottawa Rules as a protocol for treating ankle sprains in the emergency department of a university hospital. Methods: This is a retrospective observational study, conducted over a period of three months before and three months after implementation of the protocol. Results: In the first phase, all patients complaining of ankle sprain underwent radiographs. In the second phase, after the application of the OAR, out of 85 patients evaluated, only 58 underwent complementary exams, showing a reduction of 31.8% in the request for imaging exams. There was no significant difference in fracture detection between the two groups (p=0.476). Conclusion: The OAR can be used as a tool in diagnosing ankle sprains, and their implementation reduced the request for imaging exams. Level of Evidence III, Retrospective Comparative Study.

show abstract

“… 7 The negative predictive value is also 100%, meaning that the use of the protocol has proved useful in excluding the diagnosis of fractures. 11 …”

Section: Introductionmentioning

confidence: 99%

Implementation of Ottawa Ankle Rules in University Hospital Emergency Room: Pilot Study

SCHIPER,

RODRIGUES,

REIS

et al. 2023

Acta ortop. bras.

View full text Add to dashboard Cite

show abstract

“…Outro estudo realizado por LavradorFilho et al (2020) em um hospital de traumatologia, em que estudantes de medicina e residentes de ortopedia aplicaram o Protocolo de Ottawa sobre entorses de tornozelo e avaliaram 233 pacientes, ao qual logo após os critérios de inclusão restaram 226 casos. Os dados finais apresentaram concordância entre os universitários e residentes quanto à aplicabilidade do protocolo de Ottawa nos atendimentos de urgência e emergência no Brasil.Em uma pesquisa comparativa do efeito do treinamento proprioceptivo no tornozelo entre não atletas e jogadores de voleibol, os autoresCristofoli et al (2016) constataram que o treino de propriocepção é válido para o aumento da estabilidade tanto de sedentários, quanto de atletas, incluindo ainda que esse treinamento pode ser um meio eficaz para prevenir futuras lesões.…”

unclassified

Diferentes tipos de abordagens aplicadas na reabilitação de entorses de tornozelo: revisão de literatura

Vieira¹,

Moura

Oliveira³

et al. 2022

Braz. J. of Sci.

View full text Add to dashboard Cite

Estima-se que as lesões por entorse de tornozelo aconteçam à razão de 01 para cada 10 mil pessoas diariamente, na qual a fisioterapia, deve fornecer um programa de tratamento específico alivie os problemas de muitos pacientes. A partir disso, este estudo objetivou verificar a reabilitação de entorses de tornozelo. Para tanto, foi realizada uma revisão da literatura com base em publicações dos últimos 5 anos nas bases de dados PubMed, Scielo e PEDro. Os resultados mostraram que são tipos de reabilitação para entorse de tornozelo a facilitação neuromuscular proprioceptiva do tríceps sural associada a neuro estimulação elétrica transcutânea, a aplicação de exercícios, entre outros procedimentos. Diante disso, foi possível perceber que a reabilitação de lesões de entorse de tornozelo contempla diversos procedimentos fisioterapêuticos, dessa forma, não foi possível traçar qual o procedimento específico de maior frequência para reabilitação de entorses de tornozelo. O fisioterapeuta deve analisar o paciente e a partir dessa avaliação, definir qual procedimento de maior eficácia para o quadro clínico apresentado.

show abstract

Diagnostic accuracy of the Ottawa ankle rule to exclude fractures in acute ankle injuries in adults: a systematic review and meta-analysis

Gomes

Chau

Banwell

et al. 2022

BMC Musculoskelet Disord

View full text Add to dashboard Cite

Background Ankle traumas are common presenting injuries to emergency departments in Australia and worldwide. The Ottawa Ankle Rules (OAR) are a clinical decision tool to exclude ankle fractures, thereby precluding the need for radiographic imaging in patients with acute ankle injury. Previous studies support the OAR as an accurate means of excluding ankle and midfoot fractures, but have included a paediatric population, report both the ankle and mid-foot, or are greater than 5 years old. This systematic review and meta-analysis aimed to update and assess the existing evidence of the diagnostic accuracy of the Ottawa Ankle Rule (OAR) acute ankle injuries in adults. Methods A systematic search and screen of was performed for relevant articles dated 1992 to 2020. Prospective and retrospective studies documenting OAR outcomes by physicians to assess ankle injuries were included. Critical appraisal of included studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool. Outcomes related to psychometric data were pooled using random effects or fixed effects modelling to calculate diagnostic performance of the OAR. Between-study heterogeneity was assessed using the Higgins I2 test, with Spearman’s correlation test for threshold effect. Results From 254 unique studies identified in the screening process, 15 were included, involving 8560 patients from 13 countries. Sensitivity, specificity, negative likelihood ratio, positive likelihood ratio and diagnostic odds ratio were 0.91 (95% CI, 0.89 to 0.92), 0.25 (95% CI, 0.24 to 0.26), 1.47 (95% CI, 1.11 to 1.93), 0.15 (95% CI, 0.72 to 0.29) and 10.95 (95% CI, 5.14 to 23.35) respectively, with high between-study heterogeneity observed (sensitivity: I2 = 94.3%, p < 0.01; specificity: I2 = 99.2%, p < 0.01). Most studies presented with low risk of bias and concern regarding applicability following assessment against QUADAS-2 criteria. Conclusions Application of the OAR is highly sensitive and can correctly predict the likelihood of ankle fractures when present, however, lower specificity rates increase the likelihood of false positives. Overall, the use of the OAR tool is supported as a cost-effective method of reducing unnecessary radiographic referral, that should improve efficiency, lower medical costs and reduce waiting times.

show abstract

Aplicação do protocolo Ottawa por estudantes de medicina e residentes de ortopedia em entorses de tornozelo em um hospital de trauma

Cited by 4 publications

References 9 publications

Implementation of Ottawa Ankle Rules in University Hospital Emergency Room: Pilot Study

Implementation of Ottawa Ankle Rules in University Hospital Emergency Room: Pilot Study

Diferentes tipos de abordagens aplicadas na reabilitação de entorses de tornozelo: revisão de literatura

Diagnostic accuracy of the Ottawa ankle rule to exclude fractures in acute ankle injuries in adults: a systematic review and meta-analysis

Contact Info

Product

Resources

About