Ankle Trauma in Children, Application of Ottawa Ankle Rules From 5 Years Old, What is the Impact

Study Overview
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Brief Summary
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Ankle sprain in children is a very common pathology. Currently in France, a standard X-ray is done in almost all cases. However, the literature has for several years validated the consideration of the Ottawa ankle rules in children to avoid the realization of these X-rays. Our study is an evaluation of clinical practice. The aim is to assess the impact of the implementation of a new protocol using the Ottawa ankle rules from the age of 5. In particular, radiographic sparing and absence of diagnostic error.

Detailed Description
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Main objective: To compare the rate of X-rays performed before and after implementation of the protocol in pediatric emergencies. Secondary objectives (if applicable): Compare the time spent in the emergency room of patients before and after implementation of the protocol Evaluate the gain in terms of cost for the healthcare system Evaluate the adherence of caregivers to compliance with the protocol Evaluate the decrease in the rate of X-rays performed in different age groups. Evaluation of the consultation rate in the month for the same reason Primary endpoint = X-ray rate as a % of X-rays performed on the number of children presenting to pediatric emergencies over the period studied (before implementation of the protocol in a similar period = May to October 2022 / after implementation of the protocol = May to October 2023) Secondary endpoints = Time spent in the emergency room in min Estimation of the cost for the healthcare system by taking the cost of an x-ray and evaluating the gain on the reduction in the rate of x-rays performed (number of x-rays - cost of an x-ray) Evaluation of caregiver compliance by measuring the number of X-rays performed outside the protocol (X-ray performed despite the absence of Ottawa criteria) X-ray rate by age group Spontaneous reconsultation rate within 1 month

Official Title
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Ankle Trauma in Children, Application of Ottawa Ankle Rules From 5 Years Old, What is the Impact

Conditions
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Sports Injuries in Children

Intervention / Treatment
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* Diagnostic Test: OTTAWA ANKLE RULES


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 5 to 18 years old consulting in pediatric emergency in Nancy children hospital for ankle injury Exclusion Criteria: Constitutional bone disease Polytrauma Inability to assess the patient (inebriated, altered consciousness, neurosensitive disease, intoxication) Non-acquired walking Injury more than 10 days old Patient re-consults for the same injury previously assessed in the same centre Patient with previous radiographs prior to consultation Open fracture Sensory or vascular deficit Haemophilia Metabolic disease with proven osteopenia

Ages Eligible for Study
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Minimum Age: 5 Years
Maximum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| before protocol<br>patients between 5 and 18 years of age consulting the paediatric emergency department for ankle trauma, before protocol implementation. | |
| after protocol<br>patients between 5 and 18 years of age consulting the paediatric emergency department for ankle trauma, after the implementation of the protocol | Diagnostic Test: OTTAWA ANKLE RULES<br>* count the ottawa score and do an x-ray if the score is greater than or equal to 1<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| COMPARISON of the rate of x-rays | COMPARISON of the rate of x-rays as a % of x-rays performed among the number of children presenting to paediatric emergency departments over the period studied before and after implementation of the protoc | 4 month | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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ankle children Ottawa