URG-L: Pittsburgh Lions vs Ottawa Bears

[axel ellrodt]

Utilisez-vous de façon systématique les règles d'Ottawa et / ou celles de Pittsburg dans les traumas du genou et pourquoi l'une plutôt que l'autre ? ou la "mieux-disante" pour un blessé donné ?
rappel:

Ottawa knee rules

A knee radiograph is indicated only in patients with acute knee injuries and one or more of the following five conditions:

  1.Blunt knee trauma in a patient > 55 years old
  2.Tenderness of the head of the fibula on palpation
  3.Isolated tenderness of the patella
  4.Inability to flex the knee to 90 degrees
  5.Inability to bear weight both immediately and inability to take four steps in the ED

Exclusion criteria include:

  1.Isolated skin injuries (i.e., superficial abrasions/lacerations)
  2.Referred patients from another ED or clinic
  3.Injury greater than 7 days old
  4.Patient returning for re-evaluation
  5.Distracting injuries (multiple trauma)
  6.Altered mental status
  7.Age < 18 years old
  8.Pregnant patients
  9.Paraplegia

Pittsburgh decision rules

Blunt trauma or a fall as mechanism of injury plus either of the following:

Age younger than 12 years or older than 50 years
Inability to walk four weight-bearing steps in the emergency department

Exclusion criteria for the Pittsburgh Rules for Knee Radiographs include

  1.Injury >6 days old
  2.Isolated skin injuries (i.e., superficial abrasions/lacerations)
  3.History of knee fracture or surgery
4.Repeat visit for the same injury

--
Dr Axel Ellrodt
Essonne, France
http://zzorglub.ifrance.com/
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