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MEDICINA DELLO SPORT
A Journal on Sports Medicine
Official Journal of the Italian Sports Medicine Federation
Indexed/Abstracted in: BIOSIS Previews, EMBASE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 0,163
Medicina dello Sport 2007 March;60(1):109-14
Sprain ankle during sport activity: rx imaging is always useful?
Sinno C., D’Ambrosio L., Maragno M., Bigherati S., Montemurro B., Guerra G.
Dipartimento Emergenza Accettazione, Matera
Aim. Evaluate incidence of ankle sprain injury admitted to Emergency Departement and during sport activity; outline incidence of associated fractures and related costs by Rx imaging; testing clinical rules in order to reduce costs by unnecessary Rx imaging.
Methods. We evaluated data from a retrospective study on 2559 ankle sprain injuries admitted to hospital (Emergency Departement, Matera) from july 2002 to july 2005; amount of Rx imaging requested, related costs and incidence of ankle sprain injury during sport activity were also evaluated; 227 subjects, age range from 12 to 65, who had isolated ankle sprain injury, without mental status modification by intoxication or neurologic involvment, were evaluated by authors using Ottawa Ankle Rules (OAR). Waiting list time in the Emergency Departement was evaluated using t-Student test (p<0.05).
Results. Data from our Emergency Departe-ment showed that sport activity injury was the third cause of traumatic event, following car accident and occupational injury. Injury most frequently detected was ankle sprain (after cervical rachis); ankle sprain injury during sport activity resulted the most frequent traumatic event after accidental injury. In 548 (21.41%) out of 2559 ankle sprain injuries fractures were detected after Rx imaging, 18 (4.11%) in sport related ankle sprain injury. Costs by ankle Rx imaging amonted for € 41.495, following costs from cervical rachis Rx imaging. In 4 (1.76%) of 227 patients evaluated using O.A.R fractures were missed. Use of O.A.R.allowed striking of 34.37% of Rx imaging requested and a significative reduction (p<0.001) of waiting list time in the Emergency Departement.
Conclusions. Evidence from literature and our experience suggests several reasons to advice the use of guide-lines in order to reduce cost, waiting list, unnecessary Rx exposure in the presence of ankle sprain injury during sport activity. OAR are effective in diagnosis, avoid Rx exposure, strike costs by unnecessary Rx imaging.