Ottawa ankle rules: Difference between revisions
 
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*Nearly 100% sensitive
==Background==
*Can reduce ED utilization of xrays<ref>Stiell, IG, et al. Implementation of the Ottawa Ankle Rules. JAMA. 1994; 271:827-832.</ref>
*Nearly 100% sensitive<ref>Bachmann LM, Kolb E, Koller MT, et al. Accuracy of Ottawa ankle rules to exclude fractures of the ankle and mid-foot: systematic review. BMJ. 2003; 326(7386):417.</ref>
==Ankle==
*98.5% sensitive in the pediatric population<ref>Dowling S, Spooner CH, Liang Y, et al. Accuracy of Ottawa Ankle Rules to exclude fractures of the ankle and midfoot in children: a meta-analysis. Acad Emerg Med. 2009; 16(4):277-87.</ref>
*Can reduce ED utilization of x-rays<ref>Stiell, IG, et al. Implementation of the Ottawa Ankle Rules. JAMA. 1994; 271:827-832.</ref>


*X-ray is only required if there is pain in the malleolar zone AND any of these findings:
==Criteria==
**Bony tenderness along the posterior edge or distal 6 cm of medial or lateral malleolus
{{Ottawa Ankle Rules}}
**Inability to bear weight immediately after injury AND for at least four steps at the time of ED or doctor's office evaluation


==Foot==
{{Ottawa Foot Rules}}
*X-ray is only required if there is pain in midfoot zone AND any of these findings:
**Bony tenderness over the navicular bone
**Bony tenderness over base of the 5th metatarsal
**Inability to bear weight immediately after injury AND for at least four steps at the time of ED or doctor's office evaluation


==Exceptions==
===Exceptions===
#Age <6 or >55
#Age <6 or >55
#Only for blunt trauma mechanism
#Only for blunt trauma mechanism
#Does not apply to subacute/chronic injuries
#Does not apply to subacute/chronic injuries
#Does not apply to injuries of the hindfoot or forefoot
#Does not apply to injuries of the hindfoot or forefoot
==Imaging==
[[File:Ottawa.jpg]]


==External Links==
==External Links==
Line 32: Line 25:
*[[Ottawa Knee Rules]]
*[[Ottawa Knee Rules]]


==Sources==
==References==
<references/>
<references/>
#Bachmann LM, Kolb E, Koller MT, et al. Accuracy of Ottawa ankle rules to exclude fractures of the ankle and mid-foot: systematic review. BMJ. 2003 Feb 22;326(7386):417.
#Bauer SJ, Hollander JE, Fuchs SH, et al. A clinical decision rule in the evaluation of acute knee injuries.J Emerg Med. 1995 Sep-Oct;13(5):611-5.
#Dowling S, Spooner CH, Liang Y, et al. Accuracy of Ottawa Ankle Rules to exclude fractures of the ankle and midfoot in children: a meta-analysis. Acad Emerg Med. 2009 Apr;16(4):277-87.
#Stiell IG, Greenberg GH, McKnight RD, et al. A study to develop clinical decision rules for the use of radiography in acute ankle injuries. Ann Emerg Med. 1992 Apr;21(4):384-90.
#Stiell IG, McKnight RD, Greenberg GH, et al. Implementation of the Ottawa ankle rules. JAMA. 1994 Mar 16;271(11):827-32.
#Stiell I, Wells G, Laupacis A, et al. Multicentre trial to introduce the Ottawa ankle rules for use of radiography in acute ankle injuries. Multicentre Ankle Rule Study Group. BMJ. 1995 Sep 2;311(7005):594-7.


[[Category:Ortho]]
[[Category:Orthopedics]]

Latest revision as of 22:13, 27 March 2024

Background

  • Nearly 100% sensitive[1]
  • 98.5% sensitive in the pediatric population[2]
  • Can reduce ED utilization of x-rays[3]

Criteria

Ottawa ankle rule

Ottawa ankle rule

Ankle x-ray needed if:

  • Pain near the maleoli AND
  • Inability to bear weight immediately and in the ED (4 steps) OR
  • Tenderness at posterior edge or tip of lateral malleolus OR
  • Tenderness at posterior edge or tip of medial malleolus

Ottawa foot rules

Ottawa foot rules

Foot x-ray series needed if:

  • Pain in the midfoot AND
  • Inability to bear weight both immediately and in the ED (4 steps) OR
  • Tenderness at the navicular OR
  • Tenderness at the base of the 5th metatarsal

Exceptions

  1. Age <6 or >55
  2. Only for blunt trauma mechanism
  3. Does not apply to subacute/chronic injuries
  4. Does not apply to injuries of the hindfoot or forefoot

External Links

MDCalc - Ottawa Ankle Rules

See Also

References

  1. ↑ Bachmann LM, Kolb E, Koller MT, et al. Accuracy of Ottawa ankle rules to exclude fractures of the ankle and mid-foot: systematic review. BMJ. 2003; 326(7386):417.
  2. ↑ Dowling S, Spooner CH, Liang Y, et al. Accuracy of Ottawa Ankle Rules to exclude fractures of the ankle and midfoot in children: a meta-analysis. Acad Emerg Med. 2009; 16(4):277-87.
  3. ↑ Stiell, IG, et al. Implementation of the Ottawa Ankle Rules. JAMA. 1994; 271:827-832.
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