Experience using the «Shetty test» for initial foot and ankle fracture screening in the Emergency Department

Abstract

Objective: The indiscriminate practice of radiographs for foot and ankle injuries is not justified and numerous studies have corroborated the usefulness of clinical screening tests such as the Ottawa Ankle Rules. The aim of our study is to clinically validate the so-called Shetty Test in our area.

Material and method: A cross-sectional observational study by applying the Shetty test to patients seen in the Emergency Department.

Results: We enrolled 100 patients with an average age of 39.25 (16-86). The Shetty test was positive on 14 occasions. Subsequent radiography revealed a fracture in 10 cases: 4 were false positives. The test was negative in the remaining 86 patients and radiography confirmed the absence of fracture (with sensitivity of 100% and specificity of 95.56%, positive predictive value of 71.40%, and negative predictive value of 100%).

Conclusions: The Shetty test is a valid clinical screening tool to decide whether simple radiography is indicated for foot and ankle injuries. It is a simple, quick and reproducible test.

Keywords: Ankle; Ankle sprain; Esguince de tobillo; Foot; Ottawa ankle rules; Pie; Reglas del tobillo de Ottawa; Shetty's test; Test de Shetty; Tobillo.