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dc.contributor.authorAyre, Colin A.*
dc.contributor.authorHardy, Maryann L.*
dc.contributor.authorScally, Andy J.*
dc.contributor.authorRadcliffe, G.*
dc.contributor.authorVenkatesh, R.*
dc.contributor.authorSmith, J.*
dc.contributor.authorGuy, S.*
dc.date.accessioned2017-02-14T10:12:22Z
dc.date.available2017-02-14T10:12:22Z
dc.date.issued2017
dc.identifier.citationAyre C, Hardy ML, Scally AJ et al (2017) The use of history to identify anterior cruciate ligament injuries in the acute trauma setting: the 'LIMP index'. Emergency Medicine Journal. 34(5): 302-307.en_US
dc.identifier.urihttp://hdl.handle.net/10454/11344
dc.descriptionYesen_US
dc.description.abstractObjective To identify the injury history features reported by patients with ACL injuries and determine whether history may be used to identify patients requiring follow-up appointments from acute trauma services. Multi-site cross-sectional service evaluation using a survey questionnaire design conducted in the UK. The four injury history features investigated (LIMP) were ‘Leg giving way at the time of injury’, ‘Inability to continue activity immediately following injury’, ‘Marked effusion’ and ‘Pop (heard or felt) at the time of injury’. 194 patients with ACL injury were identified of which 165 (85.5%) attended an acute trauma service. Data on delay was available for 163 (98.8%) of these patients of which 120 (73.6%) had a follow-up appointment arranged. Patients who had a follow-up appointment arranged waited significantly less time for a correct diagnosis (geometric mean 29 vs 198 days; p<0.001) and to see a specialist consultant (geometric mean 61 vs 328 days; p<0.001). Using a referral threshold of any 2 of the 4 LIMP injury history features investigated, 95.8% of patients would have had a follow-up appointment arranged. Findings support the value of questioning patients on specific injury history features in identifying patients who may have suffered ACL injury. Using a threshold of 2 or more of the 4 LIMP history features investigated would have reduced the percentage of patients inappropriately discharged by 22.2%. Evidence presented suggests that this would significantly reduce the time to diagnosis and specialist consultation minimising the chance of secondary complications.en_US
dc.language.isoenen_US
dc.relation.isreferencedbyhttp://dx.doi.org/10.1136/emermed-2015-205610en_US
dc.rights(c) 2017 The Authors. Full-text reproduced in accordance with the publisher's self-archiving policy.en_US
dc.subjectAnterior cruciate ligament; Delayed diagnosis; ACLen_US
dc.titleThe use of history to identify anterior cruciate ligament injuries in the acute trauma setting: the 'LIMP index'en_US
dc.status.refereedYesen_US
dc.date.Accepted2017-01-06
dc.date.application2017-01-31
dc.typeArticleen_US
dc.type.versionAccepted Manuscripten_US
refterms.dateFOA2018-07-26T09:44:39Z


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