The relevance of hearing a crack in ankle injuries.
OBJECTIVE
To examine the predictive value of a crack noise or sensation in the history of injury in the diagnosis of ankle fracture.


METHODS
A short questionnaire was filled in on 464 patients with isolated ankle injuries attending the accident and emergency department in a three month period from July to September. These patients were seen in the usual way in the department and the need for x ray assessed according to clinical judgement and existing departmental guidelines. Cases which subsequently proved to be other than ankle injuries, for example, fractured calcaneus, were excluded from the study.


RESULTS
A positive history of hearing or feeling a crack did not indicate the need for an x ray or increase the possibility of a fracture; indeed the history of a crack made the presence of a fracture less likely. The clinical diagnosis of absence of fracture without radiological examination may require careful explanation to the patient.


CONCLUSIONS
Hearing a crack in the ankle does not suggest a fracture.
Reid
P M
PM
Department of Accident and Emergency Medicine, Addenbrooke's Hospital, Cambridge.
Aggarwal
A K
AK
Browning
C
C
Nicolai
P
P
D016512:Ankle Injuries / Q000175:diagnosis* / Q000000981:diagnostic imaging; D005596:Fractures, Closed / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006801:Humans; D009622:Noise; D011859:Radiography