Citation

Morris N, Lovell ME. Injury 2013; 44(7): 998-1001.

Affiliation

University Hospital South Manchester NHS Trust, Wythenshawe, Manchester, M23 9LT, UK.

Copyright

(Copyright © 2013, Elsevier Publishing)

DOI

10.1016/j.injury.2013.01.030

PMID

23415389

Abstract

INTRODUCTION: An audit took place to look at the diagnostic or pick-up rate of ankle fractures. A seasonal variation was discovered. Although it is expected that more fractures may be seen in wet or icy periods, an excess of X-rays taken in the summer months has not been previously registered. METHOD: An automated X-ray system was looked at to see the number of X-rays taken and the diagnostic yield. RESULTS: We reviewed ankle X-rays of 3929 patients over a 24-month period between 1 July 2009 and 31 June 2011; of which, 612 patients were found to have fractured their ankle giving a pick-up rate of 0.16. This is less than what might be expected with strict application of Ottawa rules. The pick-up rate fluctuated each month from an admirable 0.35 fractures per X-ray ordered in December 2009 to a lowly 0.06 fractures per X-ray in May 2010. The same pattern was noted for the other year. For both Decembers, the fewest number of X-rays were taken at 80 and 140, the most at 200 and 240 in May for both years. Less X-rays were taken in for all winter months. For younger age groups, males dominated with the crossover to females dominating in the fifth decade. CONCLUSION: We postulate that summertime sports and recreational injuries may cause less fractures than at winter periods but result in more X-rays taken. We have reviewed our practice to try to improve our diagnostic rates; the basic tenets of Ottawa rules including the presence of bony tenderness and weight-bearing status have been reinforced in our teaching sessions. It is highly likely that strict application of these methods will decrease the number of X-rays taken and improve our pick-up rates.

Language: en