Brooks S C, Potter B T, Rainey J B
Br Med J (Clin Res Ed). 1981 Feb 21;282(6264):607-8. doi: 10.1136/bmj.282.6264.607.
Inversion injuries of the ankle are a common cause of referral and presentation to accident units. They impose a load on radiographic services. A prospective trial was carried out to determine the accuracy of clinical examination. All patients were assessed clinically then examined radiographically, the clinical assessment missed 5% of the fractures. These, however, were all minor avulsion fractures or crush fractures and Tubigrip support was sufficient. Clinical examinations is, therefore, accurate and the need for most x-ray examination is questionable. X-ray examination should be reserved for patients with continuing pain or those who clinically have a fracture requiring immobilisation. This would produce a large saving in NHS resources.
踝关节内翻损伤是患者转诊至事故科室并前来就诊的常见原因。这类损伤给放射科服务带来了负担。开展了一项前瞻性试验以确定临床检查的准确性。所有患者先接受临床评估,然后进行放射检查,临床评估漏诊了5%的骨折。然而,这些漏诊的骨折均为轻微撕脱骨折或挤压骨折,使用弹力绷带固定就足够了。因此,临床检查是准确的,多数情况下进行X线检查的必要性存疑。X线检查应仅用于持续疼痛的患者或临床上有需要固定的骨折的患者。这将为英国国家医疗服务体系节省大量资源。