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(Created page with "==Rule== Order ankle xrays when there is any pain in the medial or lateral malleolar zone and any of these findings: 1. Bony tenderness along the posterior edge or distal 6...")
 
 
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==Rule==
==Background==
*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>
*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>


==Criteria==
{{Ottawa Ankle Rules}}


{{Ottawa Foot Rules}}


Order ankle xrays when there is any pain in the medial or lateral malleolar zone and any of these findings:
===Exceptions===
#Age <6 or >55
#Only for blunt trauma mechanism
#Does not apply to subacute/chronic injuries
#Does not apply to injuries of the hindfoot or forefoot


1. Bony tenderness along the posterior edge or distal 6cm of either malleolus
==External Links==
[http://www.mdcalc.com/ottawa-ankle-rules/ MDCalc - Ottawa Ankle Rules]


2. Inability to bear weight for at least two steps with each foot immediately after the injury and at the time of evaluation
==See Also==
*[[Ankle (Main)]]
*[[Ankle Fracture]]
*[[Foot Diagnoses]]
*[[EBQ:Ottawa Ankle Rule Study|Ottawa Ankle Rule Study]]
*[[Ottawa Knee Rules]]


==References==
<references/>


Order foot xrays when there is any pain in the mid-foot zone and any of these findings:
[[Category:Orthopedics]]
 
1. Bony tenderness over the navicular or at the base of the 5th metatarsal
 
2. Inability to bear weight for at least two steps with each foot immediately after the injury and at the time of evaluation
 
 
exceptions:
 
age 18-55
 
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)
 
 
 
 
[[Category:Ortho]]

Revisión actual - 22:13 27 mar 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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