DOCSLIB.ORG

Journal of Athletic Training

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Journal of Athletic Training JOURNAL OF ATHLETIC TRAINING Official Publication of the National Athletic Trainers’ Association, Inc Volume 46, Number 3, Supplement, 2011 2011 Free Communications Thomas Dompier, PhD, ATC Robert T. Floyd, EdD, ATC, CSCS Committee University of South Carolina The University of West Alabama Thomas Dompier, PhD, ATC, Chair Jennifer Earl-Boehm, PhD, ATC M. Susan Guyer, DPE, ATC, LAT, University of South Carolina University of Wisconsin, Milwaukee CSCS Springfield College Joseph Hart, PhD, ATC Michael Ferrara, PhD, ATC University of Virginia University of Georgia MaryBeth Horodyski, EdD, ATC University of Florida Lisa Jutte, PhD, ATC, LAC Tricia Hubbard, PhD, ATC, LAT Ball State University University of North Carolina – Robert D. Kersey, PhD, ATC, Charlotte CSCS Thomas Kaminski, PhD, ATC, FNATA California State University – University of Delaware Lennart Johns, PhD, ATC Fullerton Quinnipiac University Melanie McGrath, PhD, ATC Kenneth W. Locker, MA, ATC University of Nebraska Omaha Kristen Kucera, PhD, ATC, LAT Texas Health Sports Network Duke University Medical Center Darin Padua, PhD, ATC Tamara C. McLeod, PhD, ATC, CSCS University of North Carolina at Riann Palmieri-Smith, PhD, ATC Arizona School of Health Sciences Chapel Hill University of Michigan Valerie Moody, PhD, ATC, AT, Kimberly Peer, EdD, ATC, LAT Kimberly Peer, EdD, ATC, LAT CSCS, WEMT-B Kent State University Kent State University University of Montana William Pitney, EdD, ATC Brian Ragan, PhD, ATC Sally E. Nogle, PhD, ATC Northern Illinois University Ohio University Michigan State University Brian Ragan, PhD, ATC Eric Sauers, PhD, ATC David H. Perrin, PhD, ATC Ohio University A.T. Still University University of North Carolina at Steven Straub, ATC Sandra Shultz, PhD, ATC, FNATA Greensboro Quinnipiac University University of North Carolina at Charles J. “Charlie” Redmond, MS, Greensboro MEd, ATC Charles Thigpen, PhD, ATC, PT Springfield College Proaxis Therapy NATA Foundation Board of Directors Kavin Tsang, PhD, ATC Robb Rehberg, PhD, ATC, NREMT California State University, Fullerton Mark A. Hoffman, PhD, ATC William Paterson University President Susan Yeargin, PhD, ATC Oregon State University Clinton B. Thompson, MA, ATC Indiana State University Retired Michelle D. Boyd, MS, ATC NATA Foundation Truman State University 2011 Research Committee Robert J. Casmus, MS, ATC Darin Padua, PhD, ATC, Chair Catawba College University of North Carolina at Ralph Castle, PhD, ATC Chapel Hill Louisiana State University INDEXES: Currently indexed in PubMed Central, Focus on Sports Science & Medicine (ISI: Institute for Scientific Information), Research Alert (ISI: Institute for Scientific Information), Physical Education Index, SPORT Discus (SIRC: Sport Information Research Centre, Canada), CINAHL (Cumulative Index to Nursing & Allied Health Literature), AMED (The Allied and Alternative Medicine Database), PsycINFO (American Psychological Association), and EMBASE (Elsevier Science). The Journal of Athletic Training (ISSN 1062-6050) is published quarterly ($225 for 1-year subscription, $255 foreign) by The National Athletic Trainers’ Association, Inc, 2952 Stemmons Freeway, Dallas, TX 75247. Periodicals postage paid at Dallas, TX, and at additional mailing offices. POSTMASTER: Send address changes to: Journal of Athletic Training c/o NATA, 2952 Stemmons Freeway, Dallas, TX 75247. CHANGE OF ADDRESS: Request for address change must be received 30 days prior to date of issue with which it is to take effect. Duplicate copies cannot be sent to replace those undelivered as a result of failure to send advance notice. ADVERTISING: Although advertising is screened, acceptance of the advertisement does not imply NATA endorsement of the product or the views expressed. Rates available upon request. The views and opinions in the Journal of Athletic Training are those of the authors and not necessarily of The National Athletic Trainers’ Association, Inc. Copyright 2011 by The National Athletic Trainers’ Association, Inc. All rights reserved. Printed in the U.S.A. Journal of Athletic Training S-1 Bring this Supplement to New Orleans and use it as a guide to the Free Communications Sessions Dear NATA Members and Friends: We are pleased to present the annual Supplement to the Journal of Athletic Training. This document contains abstracts presented at the 2011 NATA Annual Meeting & Clinical Symposia as part of the National Athletic Trainers’ Association Research & Education Foundation’s Free Communications Program. The Free Communications Program provides certified athletic trainers, students and other health care providers an opportunity to present and learn about the latest in athletic training research. Research is presented in oral and poster formats and includes general research, NATA Foundation-funded research, thematic posters and clinical case reports. These presentations span a wide spectrum of topics. In addition, the Clinical Case Reports sessions allow you to test your clinical assessment skills. For your convenience, research abstracts are printed in order of presentation at the NATA Annual Meeting in New Orleans. We encourage you to attend these sessions. The NATA Foundation funds research, a variety of educational programs and annual scholarships to undergraduate and graduate athletic training students. Support from NATA members, corporations and other affiliated groups make this supplement and all of our other programs possible. Please note projects funded by the NATA Foundation are identified in this Supplement. To make an investment in the future of the profession, please contact the NATA Foundation today at 972-532-8837. NATA and its Foundation are pleased to offer this supplement as a service to NATA members. We hope it provides theoretical and practical information you can use to improve your effectiveness as a certified athletic trainer. Thank you for your support! Sincerely, Mark A. Hoffman, PhD, ATC Marjorie J. Albohm, MS, ATC President, President, NATA NATA Research & Education Foundation S-2 Volume 46 • Number 3 (Supplement) May 2011 Dear Colleagues: On behalf of the National Athletic Trainers’ Association Research & Education Foundation and the Free Communications Committee, we would like to thank the authors who submitted abstracts to the NATA Foundation’s Free Communications Program. More than 360 submissions in the Peer Reviewed and Student Exchange tracks were received for the 2011 program. This year’s Free Communications Program contains an exciting mix of both high-caliber research reports and clinical case study reports. Please keep in mind that we consider oral and poster presentations to be equal in terms of stature and we encourage clinicians and researchers to attend both oral and posters sessions. We would like to take this opportunity to extend a special thanks to the NATA Foundation staff and especially Patsy Brown, whose attention to detail and dedication makes the Free Communications Program possible. Additionally, many individuals have worked very hard to review submissions, schedule presentations and produce this Supplement to the Journal of Athletic Training. Therefore, we would like to thank and recognize the efforts of the Free Communications Committee including: Joseph Hart, PhD, ATC; Lisa Jutte, PhD, ATC, LAC; Thomas Kaminski, PhD, ATC, FNATA; Melanie McGrath, PhD, ATC; Darin Padua, PhD, ATC; Kimberly Peer, EdD, ATC, LAT; William Pitney, EdD, ATC; Brian Ragan, PhD, ATC; Steven Straub, ATC; Charles Thigpen, PhD, ATC, PT; Kavin Tsang, PhD, ATC; and Susan Yeargin, PhD, ATC for their many hours of abstract reviews and preparation for our Free Communications programming. Lastly, we wish to thank Leslie Neistadt and the staff at the editorial office of the Journal of Athletic Training for making the Supplement possible. As we move forward, we will continually try to improve and make the review process more transparent. Our goal is to be as inclusive as possible while maintaining the high level of scholarship readers expect from the Journal of Athletic Training. We appreciate the feedback we have received from authors. Suggestions are always welcomed and discussed in committee meetings to further improve the process. We look forward to seeing you in New Orleans and hope you will take the opportunity to attend the Free Communications evidenced-based forums, peer reviewed oral and poster sessions and the student exchange poster presentations. Please note that projects funded by the NATA Research & Education Foundation are specified in this Supplement. Finally, if you have the opportunity, please offer your thanks to those recognized above. Sincerely, Tom Dompier, PhD, ATC Free Communications Committee Chair Journal of Athletic Training S-3 JOURNAL OF ATHLETIC TRAINING Official Publication of the National Athletic Trainers’ Association, Inc Volume 46, Number 3, Supplement, 2011 Table of Contents Moderator(s) Page Free Communications: Room 217 Monday, June 20, 2011 8:00AM-9:00AM ........ EBF: Ankle ........................................................................................................................... S-12 9:15AMAM-10:30AM .. Clinical Ankle Measurements ....... Tricia Hubbard, PhD, ATC ............................................ S-12 10:45AM-11:45AM .... EBF: Concussion ................................................................................................................. S-15 12:00PM-1:00PM ....... Concussion Issues ..........................Ryan Tierney, PhD, ATC .............................................. S-15 Tuesday,
Load more

Recommended publications
  • Episode 35 - Pediatric Orthopedics - Emergencymedicinecases.Com
    EPISODE 35 - PEDIATRIC ORTHOPEDICS - EMERGENCYMEDICINECASES.COM KNEE INJURIES: Check the X-ray for a Segond fracture, a vertically oriented In general, children’s ligaments are avulsion fracture off the lateral stronger than their bones, thus proximal tibia. This is highly fractures are more likely than associated with ACL and meniscal sprains. Have a low threshold for tears. (See page 4 for a picture.) imaging if suspicious. Management of ACL tears: The same ACL-injury mechanism (sudden deceleration - pain management in acute phase of distal leg with forward and (NSAIDs, tylenol, morphine) rotatory movement) will cause a - short term immobilization (splint EPISODE 35: tibial spine fracture in a as needed, +/-crutches), but PEDIATRIC ORTHOPEDICS younger child, and an ACL tear in atrophy of quadriceps occurs WITH DR. SANJAY MEHTA & a teenager or adult. (See page 4 for quickly, so start range of motion in DR. JONATHAN PIRIE a photo of a tibial spine fracture.) 2–3 days. Some experts Patellar subluxations: the child Lachman test for ACL tear recommend weight bearing as may feel a “pop”, from the kneecap involves pulling the proximal tibia tolerated immediately. subluxing, and feel unstable on the anteriorly while holding the knee in - Surgical repair is delayed until leg. First time patella dislocations flexion. It has good sensitivity (>80% range of motion has recovered. and non-displaced fractures do and specificity of 95%) (1). The Refer to outpatient orthopedics. need knee immobilization, pivot shift test (valgus force and with weight bearing as tolerated. internal rotation to extended leg, Displaced fractures or fractures with which is then flexed to feel Additional X-ray views: an impaired extensor mechanism subluxation) is also sensitive for ACL - patellar injury requires a “skyline need urgent orthopedic tear.
    [Show full text]
  • Ottawa Knee Rule: Investigating Use and Application in a Tertiary Teaching Hospital
    Open Access Original Article DOI: 10.7759/cureus.8812 Ottawa Knee Rule: Investigating Use and Application in a Tertiary Teaching Hospital Abubakr Mohamed 1 , Elkhidir Babikir 1 , Mohamed Kamal Elbashir Mustafa 2 1. Emergency Medicine, University Hospital Galway, Galway, IRL 2. Vascular Surgery, University Hospital Galway, Galway, IRL Corresponding author: Abubakr Mohamed, [email protected] Abstract Background Knee injuries are encountered commonly in the emergency departments (EDs) in Ireland. Validated clinical decision rules such as Ottawa knee rule (OKR) can be used in acute knee injury settings to reduce the number of unnecessary radiography. Clinical judgment can be used to distinguish between suspected fractures and non-fractures in many cases; however, radiography is still routinely requested. Objectives We evaluated the OKRs in a high-volume tertiary teaching hospital in Ireland to determine whether the rule could be safely used to decide whether patients with acute blunt knee trauma should undergo radiography. Methods This was an observational study conducted in the ED over a three-month period in a tertiary referral hospital. A total of 110 patients with acute knee injuries were examined using OKR. Inclusion criteria included patients with acute knee injuries due to blunt trauma or twisting injury and patients with lacerations or contusions. Open fractures and fractures due to penetrating injury were excluded from the study. Results Fractures were seen in 12 (13.2%) of the 110 patents who met the inclusion criteria. The OKR predicted all 12 fractures. Sensitivity was 100%, and specificity was 39%. Conclusions Received 06/04/2020 Review began 06/18/2020 The OKR is highly sensitive for fracture in this setting and can be safely used to decide whether Review ended 06/21/2020 patients with acute blunt knee trauma should undergo radiography.
    [Show full text]
  • 1. MOA AAA 2016 Abstract
    Abstract Combined Meeting of the th Malaysian Orthopaedic 46Association Annual General Meeting / Annual Scientific Meeting th ASEAN Arthroplasty 10 Association Meeting 2016 Fundamentals In Orthopaedics – Back To Basics Pre-Conference Day Conference Days 25th May 2016 26th to 28th May 2016 Persada Johor International Convention Centre, Johor Bahru, Malaysia. www.moa-home.com Abstract CD (Please click on the links below to view the respective categories of abstracts.) Oral Presentations Abstracts Poster Presentations Abstracts (Click Here...) Combined Meeting of the 46th Malaysian Orthopaedic Association Annual General Meeting / Annual Scientific Meeting & 10th ASEAN Arthroplasty Association Meeting 2016 26th May 2016 (Thursday) - Lecture Hall MOA 1, Level 3 TIME TOPIC SPEAKER 0700 -1730 REGISTRATION COUNTER OPENS SUBIR SENGUPTA MEMORIAL LECTURE Chairperson Prof Dr Saw Aik 0830 - 0900 Prevention And Early Detection Of DDH - The Japanese SM 01 Prof Dr Makoto Kamegaya Experience OPENING CEREMONY 0900 - 1030 Orthopaedics At The Frontlines In A Changing Globalised World. SK 01 Roles And Responsibilities. Dato' Dr Ahmad Faizal Mohd Perdaus A View From A Humanitarian And Colleauge. 1030 - 1100 TEA BREAK & EXHIBIT VISIT SPORTS Dr Shamsul Iskandar Hussein Chairperson Dr Raymond Yeak Dieu Kiat Revision Anterior Cruciate Ligament Reconstruction: Analysis 1100 - 1112 SX 01 Of Causes Of Failures, Preoperative Clinical Evaluation And Dr Deepak V. Patel Planning, Surgical Technique, And Clinical Outcomes SLAP (Superior Labrum Anterior Posterior)
    [Show full text]
  • SPA Referral Guidelines
    SUTTER PHYSICIANS ALLIANCE (SPA) 2800 L Street, 7th Floor Sacramento, CA 95816 SPA Specialty Referral Guideline Pittsburg Knee Rules for Ordering Radiology Ottawa Ankle Rules for Ordering Radiology Developed May 10, 2005 Revised April 23, 2007 Reviewed July 27, 2009 I. Indications for Ordering X-ray of the Knee.......................................Page 2 II. Indications for Ordering X-ray of the Ankle .....................................Page 2 III. Indications for Ordering X-ray of the Foot ........................................Page 2 IV. Exclusion Criterion for Ankle and Foot.............................................Page 2 SPA Specialty Referral Guideline – Pittsburg Knee / Ottawa Ankle Referral Indications Revised 4/23/07 Page 2 of 2 I. Indications for Ordering X-ray of the Knee Pittsburg Knee Rules/Indications for Ordering Plain Films of the Knee A) If the patient experienced a fall or blunt trauma, and is unable to walk four (4) weight- bearing steps, an X-ray is indicated. B) If the patient experienced a fall or blunt trauma, and is under 12 or over 50 years of age, an X-ray is indicated. If the above criteria are not present, no need for X-ray. II. Indications for Ordering X-ray of the Ankle Ottawa Ankle Rules Pain in the malleolar zone and ANY of the following: A) Bony tenderness at posterior edge of distal 6cm of the lateral malleolus. B) Bony tenderness at posterior edge of distal 6cm of the medial malleolus. C) Inability to weight-bear immediately. III. Indications for Ordering X-ray of the Foot Pain in the mid-foot zone and ANY of the following: A) Bony tenderness at the base of the 5th metatarsal.
    [Show full text]
  • What Is the Best Way to Evaluate an Acute Traumatic Knee Injury?
    From the CLINICAL INQUIRIES Family Physicians Inquiries Network Matthew L. Silvis, MD, C. Randall Clinch, DO, MS, What is the best way and Janine S. Tillet, MSLS Wake Forest University, to evaluate an acute Winston-Salem, NC traumatic knee injury? Evidence-based answer Use the Ottawa Knee Rules. When there or ligamentous injury (SOR: C, based on is a possibility of fracture, they can guide studies of intermediate outcomes). the use of radiography in adults who Sonographic examination of a present with isolated knee pain. However, traumatized knee can accurately detect information on use of these rules in the internal knee derangement (SOR: C, pediatric population is limited (strength based on studies of intermediate of recommendation [SOR]: A, based on outcomes). Magnetic resonance imaging systematic review of high-quality studies (MRI) of the knee is the noninvasive and a validated clinical decision rule). standard for diagnosing internal knee Specific physical examination maneuvers derangement, and it is useful for both adult (such as the Lachman and McMurray tests) and pediatric patients (SOR: C, based on FAST TRACK may be helpful when assessing for meniscal studies of intermediate outcomes). Employ the Clinical commentary Ottawa Knee Rules Ottawa rules for ankles—yes, test, Drawer sign, and McMurray test to determine but they’re good for knees, too are useful in diagnosing the presence of whether plain The evidence presented here suggests internal ligamentous injuries without MRI, x-rays are needed a number of practical and useful and an ultrasound can help to detect knee to rule out fracture approaches for the evaluation of acute effusion when it is not clinically obvious.
    [Show full text]
  • EM Cases Digest Vol. 1 MSK & Trauma
    THE MAGAZINE SERIES FOR ENHANCED EM LEARNING Vol. 1: MSK & Trauma Copyright © 2015 by Medicine Cases Emergency Medicine Cases by Medicine Cases is copyrighted as “All Rights Reserved”. This eBook is Creative Commons Attribution-NonCommercial- NoDerivatives 3.0 Unsupported License. Upon written request, however, we may be able to share our content with you for free in exchange for analytic data. For permission requests, write to the publisher, addressed “Attention: Permissions Coordinator,” at the address below. Medicine Cases 216 Balmoral Ave Toronto, ON, M4V 1J9 www.emergencymedicinecases.com This book has been authored with care to reflect generally accepted practices. As medicine is a rapidly changing field, new diagnostic and treatment modalities are likely to arise. It is the responsibility of the treating physician, relying on his/her experience and the knowledge of the patient, to determine the best management plan for each patient. The author(s) and publisher of this book are not responsible for errors or omissions or for any consequences from the application of the information in this book and disclaim any liability in connection with the use of this information. This book makes no guarantee with respect to the completeness or accuracy of the contents within. OUR THANKS TO... EDITORS IN CHIEF Anton Helman Taryn Lloyd PRODUCTION EDITOR Michelle Yee PRODUCTION MANAGER Garron Helman CHAPTER EDITORS Niran Argintaru Michael Misch PODCAST SUMMARY EDITORS Lucas Chartier Keerat Grewal Claire Heslop Michael Kilian PODCAST GUEST EXPERTS Andrew Arcand Natalie Mamen Brian Steinhart Mike Brzozowski Hossein Mehdian Arun Sayal Ivy Cheng Sanjay Mehta Laura Tate Walter Himmel Jonathan Pirie Rahim Valani Dave MacKinnon Jennifer Riley University of Toronto, Faculty of Medicine EM Cases is a venture of the Schwartz/ Reisman Emergency Medicine Institute.
    [Show full text]
  • Comparison of Ottawa Ankle Rules and Bernese Ankle Rules in Acute Ankle and Midfoot Injuries
    ORIGINAL ARTICLE Comparison of Ottawa Ankle Rules and Bernese Ankle Rules in Acute Ankle and Midfoot Injuries Ayak ve ayak bileği yaralanmalarında Ottawa ayak bileği kuralları ve Bernese ayak bileği kurallarının karşılaştırılması Türkiye Acil Tıp Dergisi - Turk J Emerg Med 2010;10(3):101-105 Ozkan KOSE,1 Servan GOKHAN,2 Ayhan OZHASENEKLER,2 Mustafa CELIKTAS,3 Seyhmus YIGIT,3 Serkan GURCAN4 1Antalya Training and Research Hospital, SUMMARY Department of Orthopedics and Traumatology, Antalya Objective: The purpose of this study was to compare the sensitivity and specificity of Ottawa Ankle Rules (OAR) 2Diyarbakır Training and Research and Bernese Ankle Rules (BAR) in acute ankle and midfoot injuries in the emergency department. Hospital, Department of Emergency Medicine, Diyarbakır Methods: 100 consecutive patients presented to our emergency department with acute ankle and/or midfoot 3Diyarbakır State Hospital, injuries following a blunt trauma were included. Patients were physically examined and evaluated regarding the Department of Orthopedics and BAR and OAR respectively by the same emergency medicine physician. All patients were referred for standard radi- Traumatology, Diyarbakır ography of the ankle or foot or both according to the presence of pain or tenderness in one or both of these zones. 4Diyarbakır Training and Research Hospital, Radiography results were interpreted by a consultant orthopedic surgeon who had not examined the patients. Department of Orthopedics and Sensitivity, specificity, positive and negative predictive values of each test were calculated. Traumatology, Diyarbakır Results: Radiographic examinations showed 19 fractures out of 100 investigated patients. Sensitivity and specificity of OAR were 100% and 77% respectively. Sensitivity and specificity of BAR were 94% and 95% respectively.
    [Show full text]
  • Ankle-Injuries-Guideline
    RADIOGRAPHY OF THE ANKLE AND FOOT (OTTAWA ANKLE RULES) Clinical Practice Guideline | January 2007 This guideline has been adapted from the Ottawa Ankle Rules developed by Dr. Ian Stiell et al. Dr. Stiell received financial support from the Institute of Clinical and Evaluative Studies in Ontario. OBJECTIVE The Ottawa Ankle Rules will assist Alberta clinicians assess if radiography of the foot and ankle is required for adult patients presenting with blunt ankle trauma at health care facilities. TARGET POPULATION Adults, 18 years of age and older EXCLUSIONS Under 18 years of age, intoxicated, multiple painful injuries, pregnant, head injury, diminished sensation due to neurological deficit RECOMMENDATIONS An ankle x-ray series is required only if there is pain in the malleolar zone and any one of the following: o Bone tenderness along the distal 6 cm of the posterior edge of the fibula or tip of the lateral malleolus o Bone tenderness along the distal 6 cm of the posterior edge of the tibia or tip of the medial malleolus o Inability to bear weight for four steps immediately and in the emergency department A foot x-ray series is required only if there is pain in the midfoot zone and any one of the following: o Bone tenderness at the base of the 5th metatarsal o Bone tenderness at the navicular bone o Inability to bear weight for four steps both immediately and in the emergency department OTTAWA ANKLE RULES POSTER PDF http://www.ohri.ca/emerg/cdr/docs/cdr_ankle_poster.pdf (link available as of March 2014) These recommendations are systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances.
    [Show full text]
  • Acute Ankle Trauma in Adults
    For Information Only This document has been archived, much of the original content remains relevant; however, practice in this area develops continually, therefore the content of this document must be used for information only and is only valid as per the original approval date. Head Office: Level 9, 51 Druitt Street, Sydney NSW 2000, Australia Ph: +61 2 9268 9777 Email: [email protected] New Zealand Office: Floor 6, 142 Lambton Quay, Wellington 6011, New Zealand Ph: +64 4 472 6470 Email: [email protected] Web: www.ranzcr.com ABN 37 000 029 863 2015 Educational Modules for Appropriate Imaging Referrals ACUTE ANKLE TRAUMA IN ADULTS This document is part of a set of ten education modules which are aimed at improving the appropriateness of referrals for medical imaging by educating health professionals about the place of imaging in patient care. PUBLICATION INFORMATION: ©Royal Australian and New Zealand College of Radiologists 2015 More information is available on The Royal Australian and New Zealand College of Radiologists website: URL: http://www.ranzcr.edu.au/quality-a-safety/program/key-projects/education-modules-for- appropriate-imaging-referrals For educational purposes only. The preferred citation for this document is: Goergen S, Troupis J, Yalcin N, Baquie P and Shuttleworth G. Acute Ankle Trauma in Adults. Education Modules for Appropriate Imaging Referrals. Royal Australian and New Zealand College of Radiologists, 2015. ACKNOWLEDGEMENTS: The Educational Modules for Appropriate Imaging Referrals project is fully funded by the
    [Show full text]
  • Understanding the Role of the Ottawa Ankle Rules in Physicians’ Radiography
    Understanding the Role of the Ottawa Ankle Rules in Physicians’ Radiography Decisions: A Social Judgment Analysis Approach Ania Syrowatka Thesis submitted to the Faculty of Graduate and Postdoctoral Studies in partial fulfillment of the requirements for the M.Sc. Degree in Epidemiology Department of Epidemiology and Community Medicine Faculty of Medicine University of Ottawa © Ania Syrowatka, Ottawa, Canada, 2012 ABSTRACT Clinical decision rules improve health care fidelity, benefit patients, physicians and healthcare systems, without reducing patient safety or satisfaction, while promoting cost-effective practice standards. It is critical to appropriately and consistently apply clinical decision rules to realize these benefits. The objective of this thesis was to understand how physicians use the Ottawa Ankle Rules to guide radiography decision- making. The study employed a clinical judgment survey targeting members of the Canadian Association of Emergency Physicians. Statistical analyses were informed by the Brunswik Lens Model and Social Judgment Analysis. Physicians’ overall agreement with the ankle rule was high, but can be improved. Physicians placed greatest value on rule-based cues, while considering non-rule-based cues as moderately important. There is room to improve physician agreement with the ankle rule and use of rule-based cues through knowledge translation interventions. Further development of this Lens Modeling technique could lend itself to a valuable cognitive behavioral intervention. ii ACKNOWLEDGMENTS I would like to express my sincere gratitude to my primary supervisor, Dr. Jamie Brehaut, for his mentorship, support and scientific guidance throughout this thesis project. I would like to thank my co-supervisor, Dr. Tim Ramsay, for sharing his statistical expertise to guide analyses of this thesis.
    [Show full text]
  • Application of Ottawa Ankle Rules
    International Research Journal of Medical Sciences ____________________________________ ISSN 2320 –7353 Vol. 2(10), 7-12, October (2014) Int. Res. J. Medical Sci. Application of Ottawa Ankle Rules Singh Sudhir 1, Kumar Pankaj 2 and Gupta Prakhar 3 1Department of Orthopaedics, Era Medical College, Lucknow, INDIA 2Apollo Reach Hospital, Karimnagar, Andhra Pradesh, INDIA 3 RS Nursing home, Fatehabad, Agra, Uttar Pradesh, INDIA Available online at: www.isca.in, www.isca.me Received 30 th August 2014, revised 14 th September 2014, accepted 24 th September 2014 Abstract Ankle injury is a common injury sustained in an outdoor activity or as a sport injury presenting to the emergency department. Emergency physiciansusually order radiographs for nearly all ankle injury patients, and 85% of these are negative for fracture. So, low cost high volume tests, such as plain radiographs, contribute as much to increasing costs of providing health care as high technology, low-volume procedures. University of Ottawa (Canada) estimated that US $500 million is spent every year on ankle radiographs in North America and suggested that the money spent in negative radiographs can be better utilized elsewhere in health care systems. This prospective study was conducted in the department of Orthopaedics at B.P. Koirala Institute of health Sciences, Nepal in two phases. We validated OAR in100 patients in 1st phase and in the 2 nd phase we implemented the clinical decision rule of Ottawa ankle rule (OAR) in another 100 patients. All individuals coming to this institute with complains of ankle pain secondary to blunt ankle trauma were labeled as suspected case of ankle sprain and included in this study.
    [Show full text]
  • Pediatric Ankle Fractures
    CHAPTER 26 PEDIATRIC ANKLE FRACTURES Sofi e Pinney, DPM, MS INTRODUCTION stronger than both the physis and bone. As a result, there is a greater capacity for plastic deformation and less chance of The purpose of this review is to examine the current intra-articular fractures, joint dislocation, and ligamentous literature on pediatric ankle fractures. I will discuss the disruptions. However, ligamentous injury may be more anatomic considerations of a pediatric patient, how to common than originally believed (1). A case-control study evaluate and manage these fractures, and when to surgically by Zonfrillo et al found an association between an increased repair them. Surgical techniques and complications will be risk of athletic injury in obese children, and concluded a briefl y reviewed. higher body mass index risk factor for ankle sprains (4). Ankle fractures are the third most common fractures in Secondary ossifi cation centers are located in the children, after the fi nger and distal radial physeal fracture. epiphysis. The distal tibial ossifi cation center appears at 6-24 Approximately 20-30% of all pediatric fractures are ankle months of age and closes asymmetrically over an 18-month fractures. Most ankle fractures occur at 8-15 years old. The period fi rst central, then medial and posterior, with the peak injury age is 11-12 years, and is relatively uncommon anterolateral portion closing last at 15 and 17 years of age for under the age 5. This injury is more common in boys. females and males, respectively. The distal fi bula ossifi cation The most common cause of pediatric ankle fractures is a center appears at 9-24 months of age and closes 1-2 years rotational force, and is often seen in sports injuries associated after the distal tibial.
    [Show full text]