Ottawa Ankle Rules
Original Editor - Jill Nicole Hickey
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Purpose:[edit | edit source]
To see if there is an indication for X-rays after an acute ankle injury.[1] [2]
Variables:[edit | edit source]
- Bony tenderness along distal 6 cm of posterior edge of tibia/tip of medial malleolus
- Bony tenderness along distal 6 cm of posterior edge of fibula or tip of lateral malleolus
- Bony tenderness at the base of 5th metatarsal
- Bony tenderness at the navicular
- Inability to bear weight both immediately after injury and for 4 steps during intial evaluation[3]
Method of Use:[edit | edit source]
http://www.ohri.ca/emerg/cdr/ankle_rule_flash.html
An ankle x-ray series is only required if there is pain in the malleolar zone AND any of variables 1 OR 2 OR 5.[4]
A foot x-ray series is only required if there is pain in the midfoot zone AND any of variables 3 OR 4 OR 5.[4]
Recommendations:[edit | edit source]
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Evidence:[edit | edit source]
Sensitivity = 98% [5]
- LR = 0.10
Bachmann LM, Haberzeth S, Steurer J, ter Riet G. The accuracy of the Ottawa knee rule to rule out knee fractures: a systematic review. Ann Intern Med. 2004 Jan 20;140(2):121-4.
Recent Related Research (from Pubmed):[edit | edit source]
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References:[edit | edit source]
- ↑ Bachmann LM, Haberzeth S, Steurer J, ter Riet G. The accuracy of the Ottawa knee rule to rule out knee fractures: a systematic review. Ann Intern Med. 2004 Jan 20;140(2):121-4.
- ↑ Emparanza JI, Aginaga JR, Estudio Multicéntro en Urgencias de Osakidetza: Reglas de Ottawa (EMUORO) Group. Validation of the Ottawa Knee Rules. Ann Emerg Med. 2001 Oct;38(4):364-8.
- ↑ Flynn TW, Cleland JA, Whitman JM. User's guide to the musculoskeletal examination. Evidence in motion; 2008.
- ↑ 4.0 4.1 Stiell IG, McKnight RD, Greenberg GH, McDowell I, Nair RC, Wells GA, Johns C, Worthington JR. Implementation of the Ottawa Ankle Rules. JAMA 1994;271:827-32.
- ↑ Bachmann LM, Kolb E, Koller MT, et all. Accuracy of Ottawa ankle rules to exclude fractures of the ankle and mid-foot: systematice review. BMJ 2003; 326(7386):417.