{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T23:39:53Z","timestamp":1790811593906,"version":"4.1.0"},"reference-count":15,"publisher":"Georg Thieme Verlag KG","issue":"01","license":[{"start":{"date-parts":[[2025,3,4]],"date-time":"2025-03-04T00:00:00Z","timestamp":1741046400000},"content-version":"vor","delay-in-days":31,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev Bras Ortop (Sao Paulo)"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>Resumo<\/jats:title><jats:p>\n          Objetivo\u2003Avaliar a acur\u00e1cia das regras do tornozelo de Ottawa (RTOs) aplicadas em prontu\u00e1rios de um hospital de alta complexidade e em uma cl\u00ednica privada, assim como sua utilidade cl\u00ednica em indiv\u00edduos com idade menor ou igual a 16 anos.<\/jats:p><jats:p>\n          M\u00e9todos\u2003Trata-se de estudo observacional anal\u00edtico transversal, com coleta de dados secund\u00e1rios de um departamento de emerg\u00eancia ortop\u00e9dica e cl\u00ednica ortop\u00e9dica privada. A amostra foi representada por 144 pacientes, incluindo todos os pacientes com epis\u00f3dio torcional de tornozelo submetidos a radiografias de tornozelo e\/ou p\u00e9 quando da admiss\u00e3o. As RTOs foram adotadas como teste diagn\u00f3stico para o c\u00e1lculo da sensibilidade, da especificidade, do valor preditivo positivo (VPP), do valor preditivo negativo (VPN) e das raz\u00f5es de verossimilhan\u00e7a positivas e negativas, e o resultado do exame radiogr\u00e1fico foi considerado o pard\u00e3o-ouro.<\/jats:p><jats:p>\n          Resultados\u2003Foram selecionados 191 pacientes, 144 dos quais foram inclu\u00eddos ap\u00f3s a aplica\u00e7\u00e3o dos crit\u00e9rios de inclus\u00e3o. A sensibilidade e o VPN das RTOs na identifica\u00e7\u00e3o de fraturas foram de 100%, sendo que o teste mais sens\u00edvel e com o maior VPN foi a incapacidade de caminhar quatro passos. Identificou-se um potencial de redu\u00e7\u00e3o de 43,8% no n\u00famero total de radiografias solicitadas, caso apenas os pacientes com RTOs positivas fossem radiografados.<\/jats:p><jats:p>\n          Conclus\u00f5es\u2003As RTOs parecem ser um instrumento cl\u00ednico confi\u00e1vel no manejo das entorses de tornozelo, e s\u00e3o um protocolo cl\u00ednico \u00fatil na exclus\u00e3o de fraturas em pacientes pedi\u00e1tricos. A utiliza\u00e7\u00e3o das regras evidenciou a sua capacidade de diminuir as solicita\u00e7\u00f5es desnecess\u00e1rias de radiografias, o que minimiza a exposi\u00e7\u00e3o \u00e0 radia\u00e7\u00e3o e reduz os custos para o sistema de sa\u00fade.<\/jats:p>","DOI":"10.1055\/s-0044-1800938","type":"journal-article","created":{"date-parts":[[2025,3,5]],"date-time":"2025-03-05T00:10:26Z","timestamp":1741133426000},"page":"001-006","source":"Crossref","is-referenced-by-count":1,"title":["Regras do tornozelo de Ottawa: Um instrumento cl\u00ednico confi\u00e1vel na detec\u00e7\u00e3o de fraturas na popula\u00e7\u00e3o infantojuvenil"],"prefix":"10.1055","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4787-5819","authenticated-orcid":false,"given":"Murilo Oliveira de","family":"Carvalho","sequence":"additional","affiliation":[{"name":"Universidade do Extremo Sul Catarinense, Crici\u00fama, SC, 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