scholarly journals Accessory Ossicles in the Region of the Foot and Ankle: An Epidemiologic Survey in a Jordanian Population

Medicina ◽  
2021 ◽  
Vol 57 (11) ◽  
pp. 1178
Author(s):  
Heba Kalbouneh ◽  
Omar Alajoulin ◽  
Jamil Shawaqfeh ◽  
Ayman Mustafa ◽  
Shehab Jaber ◽  
...  
Keyword(s):  
Emergency Departments ◽  
Diagnostic Errors ◽  
Kappa Statistic ◽  
Incidence Rates ◽  
Trauma Patients ◽  
Foot And Ankle ◽  
Avulsion Fractures ◽  
Accessory Ossicles ◽  
Os Peroneum ◽  
Accessory Navicular

Background and Objectives: The incidence of accessory bones in the region of foot and ankle is quite variable between studies and are often confused with avulsion fractures in trauma patients with musculoskeletal injuries. The aim of this study was to assess the incidence of accessory ossicles of the foot and ankle according to gender, side and coexistence, and to determine how frequently accessory ossicles were misdiagnosed as avulsion fractures. Materials and Methods: Oblique and/or lateral foot radiographs of 1000 adult patients referred from emergency departments to foot and ankle clinic were retrospectively reviewed for the presence of accessory ossicles. The Kappa statistic was used in order to assess the validity of radiographic interpretation for the presence of these bones. Results: Accessory ossicles were detected in 40.2% of the radiographs. The incidence rates for the accessory ossicles in order of frequency were: Os trigonum (15.4%), accessory navicular (13.7%), os peroneum (11.5%), os vesalianum (1.1%), os supranaviculare (0.7%), os subfibulare (0.6%), os talotibiale (0.4%), os calcaneus secundarius (0.3%), os supratalare (0.3%), os infranaviculare (0.3%), os intermetatarseum (0.2%), and os subtibiale (0.1%). Coexistence of two or three ossicles in the same foot was observed in 4.4% of the cases, mostly coexistence with os peroneum (2.9%), followed by accessory navicular (1.6%). 2.7% of accessory ossicles were initially misdiagnosed as avulsion fractures at emergency departments. Interrater agreement over identification of different accessory ossicles was found to be reasonably reliable, with a Kappa greater than 0.80 for all assessed bones. Conclusions: In clinical practice, a thorough knowledge of normal anatomical variants is essential to facilitate appropriate diagnosis and treatment and can help to prevent diagnostic errors.

The Incidence of Accessory Ossicles of the Wrist: A Radiographic Study

2021 ◽  
Author(s):  
Merve Gursoy ◽  
Istemihan Coban ◽  
Berna Dirim Mete ◽  
Tugrul Bulut
Keyword(s):  
Clinical Relevance ◽  
Wrist Pain ◽  
Trauma Patients ◽  
Radiographic Study ◽  
Radiological Findings ◽  
Avulsion Fractures ◽  
Accessory Ossicles ◽  
Direct Trauma ◽  
Significant Difference ◽  
Accessory Ossicle

Abstract Objective Accessory ossicles of the wrist are generally asymptomatic and detected incidentally as radiological findings. These bones are rarely symptomatic but can produce pain in cases of impingement or direct trauma. More frequently, these bones are misinterpreted as avulsion fractures in trauma patients, which may lead to unnecessary immobilization and overtreatment. The aim of this study is to determine the incidence of accessory ossicles of the wrist and also determine if the incidence is related to age, gender, or ongoing wrist pain. Materials and Methods A total of 1146 wrist radiographs were included in the study. All radiographs were analyzed for the presence of 20 different accessory ossicles of the wrist. Patients were also divided into two groups, as with and without accessory ossicle. Two groups were compared in terms of age, gender, and side. Results About 113 accessory ossicles were detected in 111 (9.7%) radiographs. The most common accessory ossicles were os triangulare and os ulnostyloideum, and the least common accessory ossicles were os gruberi and os praetrapezium. Patients who had accessory ossicle had a significantly higher age than those who did not have accessory ossicle. There was no significant difference between the patients with and without accessory ossicle in terms of gender and side. Conclusions The results of this study showed that the most common accessory ossicles in the wrist were os triangulare and os ulnostyloideum, and the incidence of accessory bones increased with age. Clinical Relevance Since accessory ossicles of the wrist can be confused with fractures in trauma patients and are frequently ignored in patients presenting with pain, it is very important to know the incidence and distribution of these ossicles. Therefore, this study is important, in that it provides potentially guiding anatomical data for clinicians in terms of diagnosis and management.

scholarly journals Data Analysis of 1811 Major Trauma Patients Admitted to the Emergency Departments of Thirteen Hospitals

2019 ◽  
Vol 25 (2) ◽  
pp. 131-134
Author(s):  
Demet Yaldiz ◽  
◽  
Gokhan Akbulut ◽  
Murat Anil ◽  
Mustafa Onur Oztan ◽  
...  
Keyword(s):  
Data Analysis ◽  
Emergency Departments ◽  
Major Trauma ◽  
Trauma Patients

scholarly journals Rising Burden of Alcohol-Associated Foot and Ankle Fractures Presenting to U.S. Emergency Departments: 2000-2017

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0034
Author(s):  
Kevin Pirruccio ◽  
Daniel C. Farber
Keyword(s):  
Alcohol Consumption ◽  
Emergency Departments ◽  
The United States ◽  
Ankle Fractures ◽  
Foot And Ankle ◽  
New Findings ◽  
Injury Mechanisms ◽  
Simple Regression Model ◽  
National Estimates ◽  
Simple Regression

Category: Ankle, Trauma, Epidemiology Introduction/Purpose: The most frequent cause of traumatic foot and ankle fractures is a fall to the ground. Alcohol consumption, especially in excess, has the potential to impart a significant fall risk on patients by reducing postural control resulting in imbalance. However, the relationship between the consumption of alcohol and the risk of traumatic foot and ankle fracture is poorly characterized. The purpose of this study was to report national estimates, injury mechanisms, and demographic characteristics of patients presenting to U.S. emergency departments (EDs) with traumatic foot and ankle fractures associated with alcohol consumption. Methods: This cross-sectional, retrospective epidemiological study analyzes case narratives in the National Electronic Injury Surveillance System (NEISS) database to examine national estimates of traumatic foot and ankle fractures associated with alcohol consumption presenting to U.S. emergency departments between 2000 and 2017, sampling in two-year intervals. Data from the Organisation for Economic Co-operation and Development (OECD) on the “Value for Total U.S. Adult Alcohol Consumption in Liters/Capita” was used in a simple regression model to demonstrate how increased alcohol consumption in the United States has predicted changes in the national number of alcohol-associated foot and ankle fractures over time. Results: Nationally, alcohol-associated foot and ankle fractures increased significantly between the 2000-2001 (N=2,878; C.I. 1,869-3,887) and 2016-2017 (N=8,778; C.I. 6,751-10,806) periods (p<0.001). Simple regression (R2 = 0.87; p<0.001) demonstrated that in the U.S., a one-tenth increase in the total liters of alcohol consumed per capita predicted an additional 606 alcohol-associated foot and ankle fractures presenting to U.S. EDs. About two-thirds of patients suffered ankle fractures (65.6%; C.I. 61.1%-70.1%). Fractures were commonly sustained by male patients (58.4%; C.I. 53.9%-62.9%) at home (46.5%; C.I. 40.9%- 52.2%); roughly one-third of patients required admission to the hospital (29.7%; C.I. 24.5%-34.9%). The most common injury mechanisms for alcohol-associated foot and ankle fractures were falls to the ground from standing height (33.0%; C.I. 28.8%- 37.2%), and falls down stairs or steps (31.0%; C.I. 26.1%-35.9%). Conclusion: Falls to the ground mechanistically link alcohol consumption to traumatic fractures of the foot and ankle. These new findings highlight how the negative societal impacts of alcohol – and potentially other substances – may be overlooked. As a result, this information should serve as an impetus to direct national attention towards awareness and preventative measures. Furthermore, our findings may help clinicians identify, educate, and counsel patients with certain demographic risk factors for alcohol-associated foot and ankle fractures.

An Operational Framework to Study Diagnostic Errors in Emergency Departments

2019 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Prashant Mahajan ◽  
Cynthia Mollen ◽  
Elizabeth R. Alpern ◽  
Kelly Baird-Cox ◽  
Richard C. Boothman ◽  
...  
Keyword(s):  
Emergency Departments ◽  
Diagnostic Errors

What interventions could reduce diagnostic error in emergency departments? A review of evidence, practice and consumer perspectives

Diagnosis ◽  
2019 ◽  
Vol 6 (4) ◽  
pp. 325-334
Author(s):  
Breanna Wright ◽  
Nicholas Faulkner ◽  
Peter Bragge ◽  
Mark Graber
Keyword(s):  
Emergency Departments ◽  
Decision Aids ◽  
Diagnostic Errors ◽  
Diagnostic Error ◽  
Patient Perspectives ◽  
Second Opinion ◽  
Rapid Review ◽  
Consumer Perspectives ◽  
Patient Values ◽  
Academic Review

Abstract The purpose of this article is to synthesise review evidence, practice and patient perspectives on interventions to reduce diagnostic error in emergency departments (EDs). A rapid review methodology identified nine systematic reviews for inclusion. Six practice interviews were conducted to identify local contextual insights and implementation considerations. Finally, patient perspectives were explored through a citizen panel with 11 participants. The rapid review found evidence for the following interventions: second opinion, decision aids, guided reflection and education. Practitioners suggested three of the four interventions from the academic review: second opinion, decision aids and education. Practitioners suggested four additional interventions: improving teamwork, engaging patients, learning from mistakes and scheduled test follow-up. Patients most favoured interventions that improved communication through education and patient engagement, while also suggesting that implementation of state-wide standards to reduce variability in care and sufficient staffing are important to address diagnostic errors. Triangulating these three perspectives on the evidence allows for the intersections to be highlighted and demonstrates the usefulness of incorporating practitioner reflections and patient values in developing potential interventions.

Dance-related foot and ankle injuries presenting to United States Emergency Departments

2016 ◽  
Vol 22 (2) ◽  
pp. 23
Author(s):  
A. Vassallo ◽  
C. Hiller ◽  
E. Stamatakis ◽  
E. Pappas
Keyword(s):  
United States ◽  
Emergency Departments ◽  
Ankle Injuries ◽  
Foot And Ankle

scholarly journals Alcohol Interventions for Trauma Patients Treated in Emergency Departments and Hospitals

2005 ◽  
Vol 241 (4) ◽  
pp. 541-550 ◽  
Author(s):  
Larry M. Gentilello ◽  
Beth E. Ebel ◽  
Thomas M. Wickizer ◽  
David S. Salkever ◽  
Frederick P. Rivara
Keyword(s):  
Emergency Departments ◽  
Trauma Patients ◽  
Alcohol Interventions

scholarly journals Connecting and linking neurocognitive, digital phenotyping, physiologic, psychophysical, neuroimaging, genomic, & sensor data with survey data

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Charles E. Knott ◽  
Stephen Gomori ◽  
Mai Ngyuen ◽  
Susan Pedrazzani ◽  
Sridevi Sattaluri ◽  
...  
Keyword(s):  
Big Data ◽  
Survey Data ◽  
Emergency Departments ◽  
Ecological Monitoring ◽  
Data Driven ◽  
Sensor Data ◽  
Trauma Patients ◽  
Long Term Effects ◽  
Digital Phenotyping ◽  
Data Elements

AbstractCombining survey data with alternative data sources (e.g., wearable technology, apps, physiological, ecological monitoring, genomic, neurocognitive assessments, brain imaging, and psychophysical data) to paint a complete biobehavioral picture of trauma patients comes with many complex system challenges and solutions. Starting in emergency departments and incorporating these diverse, broad, and separate data streams presents technical, operational, and logistical challenges but allows for a greater scientific understanding of the long-term effects of trauma. Our manuscript describes incorporating and prospectively linking these multi-dimensional big data elements into a clinical, observational study at US emergency departments with the goal to understand, prevent, and predict adverse posttraumatic neuropsychiatric sequelae (APNS) that affects over 40 million Americans annually. We outline key data-driven system challenges and solutions and investigate eligibility considerations, compliance, and response rate outcomes incorporating these diverse “big data” measures using integrated data-driven cross-discipline system architecture.

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