Vargish T, Clarke W R, Young R A, Jensen A
Injury. 1983 May;14(6):507-12. doi: 10.1016/0020-1383(83)90053-0.
The radiograph is rapidly superseding the clinical examination as the diagnostic tool for acute ankle injuries. Twenty-four independent variables which might help distinguish between soft tissue injuries and fractures at the ankle were identified and then used prospectively to study 150 consecutive patients with ankle injuries. Nineteen patients had fractured ankles (12.7 per cent) and 131 (87.3 per cent) had soft tissue injuries. Only the patient's ability to bear weight on the injured ankle and the presence of tenderness over the lateral aspect of the ankle below the malleolus proved to be helpful. When these 2 signs were present together, regardless of all other variables, there was a 97.5 per cent probability of soft tissue injury P less than 0.005). This study suggests that careful patient assessment will permit more discriminating use of ankle X-rays.
X线片作为急性踝关节损伤的诊断工具，正迅速取代临床检查。确定了24个可能有助于区分踝关节软组织损伤和骨折的独立变量，然后前瞻性地用于研究150例连续的踝关节损伤患者。19例患者踝关节骨折（12.7%），131例（87.3%）为软组织损伤。结果证明，只有患者受伤踝关节的负重能力以及外踝下方踝关节外侧的压痛对诊断有帮助。当这两个体征同时出现时，无论其他变量如何，软组织损伤的概率为97.5%（P<0.005）。这项研究表明，对患者进行仔细评估将有助于更有针对性地使用踝关节X线检查。
