Identifying Ankle Fractures

When physicians treat people with ankle injuries, fractures are sometimes missed. Connecticut residents might like to know more about these fractures and how to accurately diagnose them.

Emergency departments commonly see patients with traumatic ankle pain. Sprains are the most common ankle injuries, but medical staff must assess for fractures. A clinical tool called the Ottawa ankle rules are typically used when determining whether X-rays are needed. These rules help physicians identify where pain and tenderness are located, and X-rays may be needed depending on where the pain is and whether the ankle can bear weight.

When evaluating the effectiveness of using the Ottawa ankle rules, one study found that there was a .05 percent fracture-miss rate. Misuse of the rules and difficulty when assessing swollen ankles led to this miss rate. Around the same percentage of fractures are missed with X-rays because the images were read as negative.

X-rays are typically ordered from three viewpoints, but some institutions only use two views to save resources. Fractures are more easily identified when using three views but are found between 85-98 percent of the time when using two views.

If one suffers several injuries, ankle fractures may be missed while physicians focus on other areas. Fractures are also missed if a patient cannot relay accurate information, which might happen when inebriated or otherwise altered. Inadequate physical exams also make missing fractures possible.

Medical malpractice may occur when failure to diagnose an injury occurs. For example, a patient could suffer greater damage to a fractured ankle by walking on it if a medical professional did not diagnose the fracture. A mistake could have occurred if a thorough exam was not conducted, and an injured party might seek compensation for medical expenses in addition to future costs.