IngentaConnect The 'ABC' of examining foot radiographs

Authors: Pearse, Eyiyemi O.¹; Klass, Benjamin¹; Bendall, Stephen P.¹

Source: Annals of The Royal College of Surgeons of England, Volume 87, Number 6, November 2005 , pp. 449-451(3)

Publisher: The Royal College of Surgeons of England

Abstract:

Introduction: we report a simple systematic method of assessing foot radiographs that improves diagnostic accuracy and can reduce the incidence of inappropriate management of serious forefoot and midfoot injuries, particularly the Lisfranc-type injury.

Study Group and Methods: Five recently appointed senior house officers (SHOs), with no casualty or Orthopaedic experience prior to their appointment, were shown a set of 10 foot radiographs and told the history and examination findings recorded in the casualty notes of each patient within 6 weeks of taking up their posts. They were informed that the radiographs might or might not demonstrate an abnormality. They were asked to make a diagnosis and decide on a management plan. The test was repeated after they were taught the 'ABC' method of evaluating foot radiographs.

Results: Diagnostic accuracy improved after SHOs were taught a systematic method of assessing foot radiographs. The proportion of correct diagnoses increased from 0.64 to 0.78 and the probability of recognising Lisfranc injuries increased from 0 to 0.6.

Conclusions: The use of this simple method of assessing foot radiographs can reduce the incidence of inappropriate management of serious foot injuries by casualty SHOs, in particular the Lisfranc type injury.

Keywords: LISFRANC; FRACTURE-DISLOCATION; RADIOGRAPHS; CASUALTY

Document Type: Research article

DOI: 10.1308/003588405X51119

Affiliations: 1: Department of Trauma and Orthopaedics, Princess Royal Hospital, Haywards Heath, West Sussex, UK