Materials and Methods:Through a Cross Sectional Study Design, a total of 175 patients presenting with suspicion of ankle/mid foot fracture were selected in a consecutive manner from the OPD and subjected to detection of fracture through Ottawa Ankle Rule followed by X-ray to confirm the diagnosis of fracture. Results: The mean age group of patients in our study was 36.1+10.4 years. There were 85.7% males and 14.3% were females. The sensitivity analysis shows OAR has a sensitivity of 81.2% and specificity 61.9%., positive predictive value of the OAR is 79.1% and negative predictive value is 65.0% keeping X-ray as a gold standard. Conclusion:The overall sensitivity and specificity of the OAR lies within an acceptable range in our local population however, we still recommend further research work over it before recommendations as a routine screening test for the fracture of ankle or mid foot.
BACKGROUND Fibrous dysplasia (FD) is a developmental hamartomatous bone disease characterized by a blend of fibrous and osseous entities. Though rarely malignant, the tumor can vary from being small and asymptomatic, to a fairly large sized lesion, progressing gradually, compromising occlusion and facial esthetics. Treatment approach depends on the stage of skeletal maturity. It primarily involves surgical management for stabilizing the disease process. Post-surgical comprehensive dental treatment is necessary for restoring form and function of the jaws and teeth. This article describes comprehensive orthodontic management of severe malocclusion in a surgically operated case of FD maxilla. CASE SUMMARY A 19-year female presented with a chief complaint of excessive gingival display when smiling. Dental history included swelling of gums around the upper right front teeth, diagnosed at the age of 15 as FD of the right anterior maxillary segment and treated with surgical recontouring of the dysplastic bone. The clinical and radiological examinations showed adequate post-surgical healing. The surgically treated dysplastic area presented with right canting of the maxillary anterior occlusal plane. The maxillary teeth were torqued palatally, with the root of the right maxillary canine exposed clinically. We discuss sequential management of the associated malocclusion with comprehensive fixed orthodontics, along with special precautions taken to prevent reactivation of the quiescent and healed lesion. CONCLUSION The adequate healing of fibro-dysplastic bone post-surgery must be allowed before initiating orthodontic tooth movement in the dysplastic bone. Periodic follow-ups are needed to monitor stability of occlusion and any relapse of the lesion.
Objectives: To determine the diagnostic accuracy of Ottawa rule in ankle andmidfoot fracture keeping x-ray as gold standard. Study Design: Descriptive study. Setting:Department of Orthopedics, Lady Reading Hospital Peshawar. Period: June 2014 to May 2016.Materials and Methods: Through a Cross Sectional Study Design, a total of 175 patientspresenting with suspicion of ankle/mid foot fracture were selected in a consecutive mannerfrom the OPD and subjected to detection of fracture through Ottawa Ankle Rule followed byX-ray to confirm the diagnosis of fracture. Results: The mean age group of patients in ourstudy was 36.1+10.4 years. There were 85.7% males and 14.3% were females. The sensitivityanalysis shows OAR has a sensitivity of 81.2% and specificity 61.9%., positive predictive valueof the OAR is 79.1% and negative predictive value is 65.0% keeping X-ray as a gold standard.Conclusion: The overall sensitivity and specificity of the OAR lies within an acceptable rangein our local population however, we still recommend further research work over it beforerecommendations as a routine screening test for the fracture of ankle or mid foot.
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