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Valle, J. Valdepérez, M. Tirado, D. Verduras, C. Yus, F. Gomollón" "autores" => array:6 [ 0 => array:2 [ "nombre" => "L.M." "apellidos" => "Valle" ] 1 => array:2 [ "nombre" => "J." "apellidos" => "Valdepérez" ] 2 => array:2 [ "nombre" => "M." "apellidos" => "Tirado" ] 3 => array:2 [ "nombre" => "D." "apellidos" => "Verduras" ] 4 => array:2 [ "nombre" => "C." "apellidos" => "Yus" ] 5 => array:2 [ "nombre" => "F." 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"apellidos" => "Garcés" "email" => array:2 [ 0 => "pgarces@bifap.org" 1 => "pagarball@mundofree.com" ] "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "S." "apellidos" => "Gurucharri" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">e</span>" "identificador" => "aff0025" ] ] ] 2 => array:3 [ "nombre" => "C." 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"etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] 4 => array:3 [ "entidad" => "Hospital Virgen del Camino. Pamplona." "etiqueta" => "<span class="elsevierStyleSup">e</span>" "identificador" => "aff0025" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "*" "correspondencia" => "Correspondencia: Plaza Constantino Lorente, 16-2.° dcha. 44550 Alcorisa (Teruel)." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "The Ottawa ankle guidelines: analysis of their validity as clinical decision guidelines in the indications of x-rays for ankle and/or middle-foot traumas" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaAceptado" => "2001-03-21" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec194012" "palabras" => array:3 [ 0 => "Reglas de Ottawa" 1 => "Reglas de decisión clínica" 2 => "Traumatismos de tobillo" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec194013" "palabras" => array:3 [ 0 => "Ottawa guidelines" 1 => "Clinical decision guidelines" 2 => "Ankle traumas" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Analizar la validez de las reglas del tobillo de Ottawa (RTO) como reglas de decisión en la indicación de radiografías en los traumatismos de tobillo y/o medio pie (TTM) en nuestro medio.</p> <span class="elsevierStyleSectionTitle">Diseño</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Observacional, con aplicación de las RTO y medición prospectiva del resultado. Ámbito. Urgencias hospitalarias.</p> <span class="elsevierStyleSectionTitle">Pacientes</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Adultos que acudieron a urgencias por TTM desde el 1 de junio de 1999 al 31 de marzo de 2000. Fueron criterios de exclusión: edad menor de 18 años, embarazadas, graves alteraciones sensoriales y/o de la conciencia, politraumatizados y/o policontusionados, traumatismos de más de una semana de evolución, lesiones cutáneas secundarias al traumatismo, realización de radiografía en otro ámbito, gran inflamación o edema que impidiera la palpación de los relieves óseos.</p> <span class="elsevierStyleSectionTitle">Mediciones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Aplicación de las RTO y realización de radiografía a todos los pacientes, con independencia del resultado de aquéllas. Cálculo de sensibilidad, valor predictivo negativo, especificidad y valor predictivo positivo.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Sobre una muestra de 494 pacientes, 56 presentaron fractura (11,34%), 34 de la zona maleolar (6,9%) y 22 de la zona del medio pie (4,44%). La sensibilidad de las RTO fue del 96,43% (IC del 95%, 94,8-98%). El valor predictivo negativo fue del 97,22% (IC del 95%, 95,77-98,67%). La especificidad fue del 15,98% (IC del 95%, 12,75-19,21%) y el valor predictivo positivo, del 12,8% (IC del 95%, 9,86-15,74%).</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Las RTO son válidas en nuestro medio como reglas de decisión a la hora de solicitar radiografías en los pacientes con TTM.</p>" ] "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">To analyse the validity of the Ottawa ankle guidelines (OAG) as clinical decision guidelines in the indications of X-rays for ankle and/or middle-foot traumas in primary care.</p> <span class="elsevierStyleSectionTitle">Design</span><p id="spar0135" class="elsevierStyleSimplePara elsevierViewall">Observational, with application of the OAG and prospective measurement of the results.</p> <span class="elsevierStyleSectionTitle">Setting</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Hospital casualty.</p> <span class="elsevierStyleSectionTitle">Patients</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Adults who attended casualty for ankle or middle-foot traumas between 1st June 1999 and 31th March 2000. Criteria for exclusion were: under 18, pregnancy, grave sensory and/or awareness disturbances, multi-trauma or multi-contusion patients, traumas over a week old, skin lesions as side-effects of the trauma, X-ray in other department, high inflammation or oedema hindering palpation of bone protuberances.</p> <span class="elsevierStyleSectionTitle">Measurements</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Application of the OAG and X-ray on all patients, regardless of the result of the OAG. Calculation of sensitivity, negative predictive value, specificity and positive predictive value.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">56 of a sample of 494 patients had a fracture (11.34%), 34 in the malleolus area (6.9%) and 22 in the middle-foot area (4.44%). OAG sensitivity was 96.43% (95% CI, 94.8-98). Negative predictive value was 97.22% (95.77-98.67). Specificity was 15.98% (12.75-19.21), and positive predictive value was 12.8% (9.86-15.74).</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">The OAG are valid in primary care as guidelines to decide whether to request X-rays for patients with ankle or middle-foot traumas.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:36 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The frequency of injury, and epidemiology of ankle sprains" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "J.M. 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