Prospective survey to verify the Ottawa ankle rules

Abstract

Objective - To determine if the Ottawa ankle rules are valid in the setting of an urban teaching hospital in the UK. Design - A prospective survey. Setting - Accident and emergency department, Western Infirmary, Glasgow from 1 April 1995 to 31 August 1995. Subjects - 800 patients with an acute ankle injury. Results - 800 patients were used for analysis of which 584 (73%) were radiographed; 70 (12%) had fractures, 63 (10.8%) of which were significant. Four of these patients with fractures fulfilled none of the Ottawa ankle rules criteria for plain radiography. Conclusion - Application of the Ottawa ankle rules to this group of patients would have produced a sensitivity of 93.6%. Although useful, decision rules should be used with care and not replace clinical judgment and experience.