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Revisión actual - 09:31 22 mar 2026

Ottawa Ankle Rules

Ottawa Ankle Rule
Criteria No (0) Yes (+1)
Ankle X-ray is required if there is pain in the malleolar zone AND any of the following:
  Bone tenderness along distal 6 cm of posterior edge of tibia or tip of medial malleolus 1
  Bone tenderness along distal 6 cm of posterior edge of fibula or tip of lateral malleolus 1
  Inability to bear weight both immediately and in the ED (4 steps) 1
Foot X-ray is required if there is pain in the midfoot zone AND any of the following:
  Bone tenderness at the base of the 5th metatarsal 1
  Bone tenderness at the navicular 1
  Inability to bear weight both immediately and in the ED (4 steps) 1
Positive Criteria / 6
Interpretation
Score = 0 No X-ray needed — Sensitivity 96.4–99.6% for clinically significant fractures.
Score ≥ 1 X-ray recommended — Ankle and/or foot x-ray indicated based on positive criteria location.
References
  • Stiell IG et al. A study to develop clinical decision rules for radiography in acute ankle injuries. Ann Emerg Med. 1992;21:384-390. PMID 1554175.
  • Stiell IG et al. Decision rules for radiography in acute ankle injuries: refinement and prospective validation. JAMA. 1993;269:1127-1132. PMID 8433468.

References

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