Intrasound Vibration Testing in Acute Ankle Injuries

ABSTRACT Objectives: To determine the accuracy of intrasound vibration testing (IVT) in comparison with plain radiography in the diagnosis of acute ankle fractures. Methods: A group‐sequential, nonrandomized, double‐blind, observational study design was used. A convenience sample of patients were st...

Full description

Saved in:
Bibliographic Details
Published in:Academic emergency medicine Vol. 3; no. 9; pp. 849 - 852
Main Authors: Plewa, Michael C., Otto, Raymond, Verbrugge, John, Buderer, Nancy M. Fenn, Vaughn, Glen, Mattevi, Patricia
Format: Journal Article
Language:English
Published: Oxford, UK Blackwell Publishing Ltd 01-09-1996
Subjects:
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:ABSTRACT Objectives: To determine the accuracy of intrasound vibration testing (IVT) in comparison with plain radiography in the diagnosis of acute ankle fractures. Methods: A group‐sequential, nonrandomized, double‐blind, observational study design was used. A convenience sample of patients were studied, aged <10 years, with acute ankle injuries, undergoing ankle radiography, evaluated at a community teaching hospital ED. Excluded were cases involving injuries of <24 hours' duration, inadequate documentation, protocol violation, or positive IVT on the uninjured ankle. IVT was performed with the intrasound apparatus placed on the anterior and posterior aspects of the medial and lateral malleoli of the uninjured and injured ankles; positive IVT was defined as patient withdrawal secondary to pain. Results: Of 105 patients enrolled, 8 were excluded; 1 for inadequate documentation, 5 for protocol violation, and 2 for positive IVT of the uninjured ankle. Of the 97 patients analyzed, 13 had fractures identified by radiography, including 9 lateral malleolar, 1 medial malleolar, 1 bimalleolar, and 2 talar fractures. Only 5 of the 13 fractures were detected with IVT (sensitivity = 39%; 95% CI: 14–68%). Seventy of 84 nonfractured ankles hadnegative IVT (specificity = 83%; 95% CI: 74–91%). Of the 19 with positive IVT, 5 had fractures (positive predictive value of 26%; 95% CI: 9–51%). Of the 78 with negative IVT, 70 had no fracture (negative predictive value of 90%; 95% CI: 81–96%). Overall, 75 of 97 IVTs were correct (77%), most of which were among patients without fractures. Conclusion: IVT was not a useful test for predicting fractures in patients with acute ankle injuries.
Bibliography:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ISSN:1069-6563
1553-2712
DOI:10.1111/j.1553-2712.1996.tb03529.x