Shetty Test Challenges Ottawa Ankle Rules in Detecting Foot and Ankle Fractures: A Prospective Comparative Study
Objectives: Ankle joint injuries are among the most common orthopedic injuries and are associated with significant healthcare costs. To reduce unnecessary radiographic screening, diagnostic tools such as the widely accepted Ottawa Ankle Rules (OARs) have been developed. However, the accuracy of OARs...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Shiraz University of Medical Sciences
2025-01-01
|
| Series: | Bulletin of Emergency and Trauma |
| Subjects: | |
| Online Access: | https://beat.sums.ac.ir/article_50734_bd978809687935a0d2c2c659b62f4ac8.pdf |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850257924208721920 |
|---|---|
| author | Konstantinos Makiev Ioannis Vasios Anthimos Keskinis Reichan Molla Moustafa Georgios Petkidis Konstantinos Tilkeridis Athanasios Ververidis Efthymios Iliopoulos |
| author_facet | Konstantinos Makiev Ioannis Vasios Anthimos Keskinis Reichan Molla Moustafa Georgios Petkidis Konstantinos Tilkeridis Athanasios Ververidis Efthymios Iliopoulos |
| author_sort | Konstantinos Makiev |
| collection | DOAJ |
| description | Objectives: Ankle joint injuries are among the most common orthopedic injuries and are associated with significant healthcare costs. To reduce unnecessary radiographic screening, diagnostic tools such as the widely accepted Ottawa Ankle Rules (OARs) have been developed. However, the accuracy of OARs in excluding fractures remains uncertain. Recently, a new diagnostic test, the Shetty Test (ST), has been introduced. This prospective comparative study aimed to evaluate the diagnostic accuracy of the “ST” in comparison to the “OARs” for detecting ankle and foot fractures.Methods: A total of 112 consecutive adult patients (>18 years old) were included in the study. They were presented to the Emergency Department of a University Hospital in Alexandroupolis due to an ankle or foot injury. Data were collected over 6 months, from November 2022 to May 2023.Results: The sensitivity of the ST was 68.4%, specificity was 76.3%, positive predictive value (PPV) was 37.1%, and negative predictive value (NPV) was 92.2%. For the OARs, sensitivity was 94.7%, specificity was 15%, PPV was 18.5%, and NPV was 93.3%. When at least one of the tests was positive, the sensitivity and NPV increased to 100%.Conclusion: The ST was found to be reliable; however, it did not outperform the OARs in this study. Nevertheless, when used in conjunction, the two tests significantly improved sensitivity and the NPV. Due to its simplicity and reproducibility, the ST could be a valuable tool in daily clinical practice, particularly for non-orthopedic emergency department personnel. |
| format | Article |
| id | doaj-art-df136c99b8ba48669428d4f78872cbcf |
| institution | OA Journals |
| issn | 2322-2522 2322-3960 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Shiraz University of Medical Sciences |
| record_format | Article |
| series | Bulletin of Emergency and Trauma |
| spelling | doaj-art-df136c99b8ba48669428d4f78872cbcf2025-08-20T01:56:17ZengShiraz University of Medical SciencesBulletin of Emergency and Trauma2322-25222322-39602025-01-01131202410.30476/beat.2025.104975.155750734Shetty Test Challenges Ottawa Ankle Rules in Detecting Foot and Ankle Fractures: A Prospective Comparative StudyKonstantinos Makiev0Ioannis Vasios1Anthimos Keskinis2Reichan Molla Moustafa3Georgios Petkidis4Konstantinos Tilkeridis5Athanasios Ververidis6Efthymios Iliopoulos7Academic Department of Orthopaedics and Traumatology, University General Hospital of AlexandroupolisAcademic Department of Orthopaedics and Traumatology, University General Hospital of AlexandroupolisAcademic Department of Orthopaedics and Traumatology, University General Hospital of AlexandroupolisAcademic Department of Orthopaedics and Traumatology, University General Hospital of AlexandroupolisAcademic Department of Orthopaedics and Traumatology, University General Hospital of AlexandroupolisAcademic Department of Orthopaedics and Traumatology, University General Hospital of AlexandroupolisAcademic Department of Orthopaedics and Traumatology, University General Hospital of AlexandroupolisAcademic Department of Orthopaedics and Traumatology, University General Hospital of AlexandroupolisObjectives: Ankle joint injuries are among the most common orthopedic injuries and are associated with significant healthcare costs. To reduce unnecessary radiographic screening, diagnostic tools such as the widely accepted Ottawa Ankle Rules (OARs) have been developed. However, the accuracy of OARs in excluding fractures remains uncertain. Recently, a new diagnostic test, the Shetty Test (ST), has been introduced. This prospective comparative study aimed to evaluate the diagnostic accuracy of the “ST” in comparison to the “OARs” for detecting ankle and foot fractures.Methods: A total of 112 consecutive adult patients (>18 years old) were included in the study. They were presented to the Emergency Department of a University Hospital in Alexandroupolis due to an ankle or foot injury. Data were collected over 6 months, from November 2022 to May 2023.Results: The sensitivity of the ST was 68.4%, specificity was 76.3%, positive predictive value (PPV) was 37.1%, and negative predictive value (NPV) was 92.2%. For the OARs, sensitivity was 94.7%, specificity was 15%, PPV was 18.5%, and NPV was 93.3%. When at least one of the tests was positive, the sensitivity and NPV increased to 100%.Conclusion: The ST was found to be reliable; however, it did not outperform the OARs in this study. Nevertheless, when used in conjunction, the two tests significantly improved sensitivity and the NPV. Due to its simplicity and reproducibility, the ST could be a valuable tool in daily clinical practice, particularly for non-orthopedic emergency department personnel.https://beat.sums.ac.ir/article_50734_bd978809687935a0d2c2c659b62f4ac8.pdfottawa ankle rulesshetty testfoot and anklefracturescreening |
| spellingShingle | Konstantinos Makiev Ioannis Vasios Anthimos Keskinis Reichan Molla Moustafa Georgios Petkidis Konstantinos Tilkeridis Athanasios Ververidis Efthymios Iliopoulos Shetty Test Challenges Ottawa Ankle Rules in Detecting Foot and Ankle Fractures: A Prospective Comparative Study Bulletin of Emergency and Trauma ottawa ankle rules shetty test foot and ankle fracture screening |
| title | Shetty Test Challenges Ottawa Ankle Rules in Detecting Foot and Ankle Fractures: A Prospective Comparative Study |
| title_full | Shetty Test Challenges Ottawa Ankle Rules in Detecting Foot and Ankle Fractures: A Prospective Comparative Study |
| title_fullStr | Shetty Test Challenges Ottawa Ankle Rules in Detecting Foot and Ankle Fractures: A Prospective Comparative Study |
| title_full_unstemmed | Shetty Test Challenges Ottawa Ankle Rules in Detecting Foot and Ankle Fractures: A Prospective Comparative Study |
| title_short | Shetty Test Challenges Ottawa Ankle Rules in Detecting Foot and Ankle Fractures: A Prospective Comparative Study |
| title_sort | shetty test challenges ottawa ankle rules in detecting foot and ankle fractures a prospective comparative study |
| topic | ottawa ankle rules shetty test foot and ankle fracture screening |
| url | https://beat.sums.ac.ir/article_50734_bd978809687935a0d2c2c659b62f4ac8.pdf |
| work_keys_str_mv | AT konstantinosmakiev shettytestchallengesottawaanklerulesindetectingfootandanklefracturesaprospectivecomparativestudy AT ioannisvasios shettytestchallengesottawaanklerulesindetectingfootandanklefracturesaprospectivecomparativestudy AT anthimoskeskinis shettytestchallengesottawaanklerulesindetectingfootandanklefracturesaprospectivecomparativestudy AT reichanmollamoustafa shettytestchallengesottawaanklerulesindetectingfootandanklefracturesaprospectivecomparativestudy AT georgiospetkidis shettytestchallengesottawaanklerulesindetectingfootandanklefracturesaprospectivecomparativestudy AT konstantinostilkeridis shettytestchallengesottawaanklerulesindetectingfootandanklefracturesaprospectivecomparativestudy AT athanasiosververidis shettytestchallengesottawaanklerulesindetectingfootandanklefracturesaprospectivecomparativestudy AT efthymiosiliopoulos shettytestchallengesottawaanklerulesindetectingfootandanklefracturesaprospectivecomparativestudy |