The Shetty Test’s Performance in Predicting Fractures in Radiography for Pediatric Patients

Abstract

Objective: The objective of this study was to determine the diagnostic performance of the Shetty test (ST) in predicting fractures in pediatric ankle trauma and to prevent unnecessary radiation exposure in these cases. Materials and Methods: The ST was administered to all the patients included in the study, and the cases were categorized as ST-positive and ST-negative. The sensitivity and specificity of the test were determined based on radiographic findings. Results: The distribution of trauma mechanisms of pediatric patients was as follows: sprain (65%, n=78), fall from height (20%, n=24), direct trauma (10%, n=12), and accidental hit (10%, n=12). Radiographically, 3 (2.5%) cases showed displaced fractures, 12 (10%) showed non-displaced fractures, 1 (0.8%) showed incomplete fractures, and 104 (86.7%) showed no fractures. The sensitivity of the Shetty Test was 75%, specificity was 59.6%, positive predictive value (PPV) was 22.2%, and negative predictive value (NPV) was 93.9% in predicting the need for radiography. Conclusion: The sensitivity and specificity of the ST in predicting fractures in pediatric patients with ankle trauma within the limits of radiographic indication were found to be lower than those for adults. However, due to limited information in the literature, further studies with larger cohorts are needed.