Ottawa ankle rules: Difference between revisions
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## pain in lateral malleolar zone | ## pain in lateral malleolar zone | ||
# Inability to bear weight for at least two steps with each foot immediately after the injury and at the time of evaluation | # Inability to bear weight for at least two steps with each foot immediately after the injury and at the time of evaluation | ||
Order foot xrays when there is any pain in the mid-foot zone and any of these findings: | Order foot xrays when there is any pain in the mid-foot zone and any of these findings: | ||
Revision as of 23:28, 30 March 2011
Rule
Order ankle xrays when:
- Bony tenderness along the posterior edge or distal 6cm of either malleolus
- pain in the medial malleolar zone
- pain in lateral malleolar zone
- Inability to bear weight for at least two steps with each foot immediately after the injury and at the time of evaluation
Order foot xrays when there is any pain in the mid-foot zone and any of these findings:
- Bony tenderness over the navicular bone
- Bony tenderness over base of the 5th metatarsal
- Inability to bear weight for at least two steps with each foot immediately after the injury and at the time of evaluation
Exceptions
- ?age <18 or >55
- doesn't apply to pediatrics
- only for blunt trauma mechanism
- doesn't apply to subacute/chronic injuries
- doesn't apply to injuries of the hindfoot or forefoot
0.5% of pt's not xrayed were found to have minor fractures on follow up xray in 5-7 days.
Although it doesn't apply to peds, a study of 1500 patients age 1-15 showed a sensitivity of 98% (Journal of Acc/Emerg Med 1999;16:342-344)