Should plain X-rays be routinely performed after blunt knee trauma? A prospective analysis.
BACKGROUND
We tested the hypothesis that it was possible to decrease the number of performed x-rays after a knee trauma without delayed fracture diagnosis by using the Ottawa knee rules.


METHODS
Patients had routine x-rays of the injured knee during the first stage of the study and selective x-rays during the second stage. All patients were followed up to 6 months after the trauma.


RESULTS
138 patients were included in the first stage; 57 had negative Ottawa criteria: no fracture was observed; following the Ottawa rules, 41% of the x-rays could have been avoided. 178 patients were included in the second stage; 63 patients had negative Ottawa criteria: no fracture was diagnosed during the whole follow-up; 35% of the x-rays have been avoided.


CONCLUSIONS
Ottawa rules allowed decreasing the number of x-rays performed after a knee trauma by 35% with a sensitivity for a knee fracture detection of 100%.
Centre de Traumatologie et d'Orthopedie, 10 avenue Baumann, F-67400 Illkirch-Graffenstaden, France. jean-yves.jenny@evc.net
Jean-Yves
JY
Jenny
Cyril
C
Boeri
Hakima
H
El Amrani
Jean-Claude
JC
Dosch
Michel
M
Dupuis
Akli
A
Moussaoui
Fabrice
F
Mairot
D000368:Aged; D003657:Decision Making; D006801:Humans; D007718:Knee Injuries / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D011859:Radiography / Q000706:statistics & numerical data*; D012680:Sensitivity and Specificity; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging*