The Practice of Ottawa Ankle Rules in radiographs taken for acute ankle and midfoot injury

10.5580/62a ◽  
2008 ◽  
Vol 8 (1) ◽  
Keyword(s):  
Ottawa Ankle Rules ◽  
Midfoot Injury

Validation of the Ottawa ankle rules in a Hong Kong ED

2001 ◽  
Vol 19 (5) ◽  
pp. 429-432 ◽  
Author(s):  
Man-Cheuk Yuen ◽  
Shiu-Wah Sim ◽  
Hon-Shing Lam ◽  
Wai-Kit Tung
Keyword(s):  
Hong Kong ◽  
Ottawa Ankle Rules

scholarly journals Validation of the Ottawa Ankle Rules in Children with Ankle Injuries

1999 ◽  
Vol 6 (10) ◽  
pp. 1005-1009 ◽  
Author(s):  
Amy C. Plint ◽  
Blake Bulloch ◽  
Martin H. Osmond ◽  
Ian Stiell ◽  
Hal Dunlap ◽  
...  
Keyword(s):  
Ankle Injuries ◽  
Ottawa Ankle Rules

Prospective Evaluation of the Ottawa Ankle Rules in a University Sports Medicine Center

1998 ◽  
Vol 26 (2) ◽  
pp. 158-165 ◽  
Author(s):  
John J. Leddy ◽  
Robert J. Smolinski ◽  
James Lawrence ◽  
Jody L. Snyder ◽  
Roger L. Priore
Keyword(s):  
Sports Medicine ◽  
Ankle Injuries ◽  
Fracture Rate ◽  
Malleolar Fracture ◽  
Potential Reduction ◽  
Malleolar Fractures ◽  
Ottawa Ankle Rules ◽  
Clinically Significant ◽  
Sensitivity Specificity ◽  
Fracture Identification

In a sports medicine center, we prospectively evaluated the Ottawa Ankle Rules over 1 year for their ability to identify clinically significant ankle and midfoot fractures and to reduce the need for radiography. We also developed a modification to improve specificity for malleolar fracture identification. Patients with acute ankle injuries ( 10 days old) had the rules applied and then had radiographs taken. Sensitivity, specificity, and the potential reduction in the use of radiography were calculated for the Ottawa Ankle Rules in 132 patients and for the new “Buffalo” rule in 78 of these patients. There were 11 clinically significant fractures (fracture rate, 8.3% per year). In these 132 patients, the Ottawa Ankle Rules would have reduced the need for radiography by 34%, without any fractures being missed (sensitivity 100%, specificity 37%). In 78 patients, the specificity for malleolar fracture for the new rule was significantly greater than that of the Ottawa Ankle Rules malleolar rule (59% versus 42%), sensitivity remained 100%, and the potential reduction in the need for radiography (54%) was significantly greater. The Ottawa Ankle Rules could significantly reduce the need for radiography in patients with acute ankle and midfoot injuries in this setting without missing clinically significant fractures. The Buffalo modification could improve specificity for malleolar fractures without sacrificing sensitivity and could significantly reduce the need for radiography.

scholarly journals A multifaceted strategy for implementation of the Ottawa ankle rules in two emergency departments

BMJ ◽  
2009 ◽  
Vol 339 (aug12 3) ◽  
pp. b3056-b3056 ◽  
Author(s):  
T. Bessen ◽  
R. Clark ◽  
S. Shakib ◽  
G. Hughes
Keyword(s):  
Emergency Departments ◽  
Ottawa Ankle Rules

Ottawa ankle rules: Authors' reply

BMJ ◽  
2003 ◽  
Vol 326 (7399) ◽  
pp. 1147-c-1147 ◽  
Author(s):  
L. M Bachmann
Keyword(s):  
Ottawa Ankle Rules

Accuracy of the Ottawa Ankle Rules applied by non-physician providers in a pediatric emergency department

CJEM ◽  
2017 ◽  
Vol 20 (5) ◽  
pp. 746-752
Author(s):  
Joe MacLellan ◽  
Teya Smith ◽  
Jason Baserman ◽  
Shawn Dowling
Keyword(s):  
Phase 1 ◽  
Clinical Decision ◽  
Pediatric Emergency ◽  
Observer Agreement ◽  
Physician Assessment ◽  
Ottawa Ankle Rules ◽  
Fractures In Children ◽  
Care Workers ◽  
Foot Injury ◽  
Clinically Significant

AbstractObjectiveThe Ottawa Ankle Rules (OAR) are a clinical decision tool used to minimize unnecessary radiographs in ankle and foot injuries. The OAR are a reliable tool to exclude fractures in children over 5 years of age when applied by physicians. Limited data support its use by other health care workers in children. Our objective was to determine the accuracy of the OAR when applied by non-physician providers (NPP).MethodsChildren aged 5 to 17 years presenting with an acute ankle or foot injury were enrolled. Phase 1 captured baseline data on x-ray use in 106 patients. NPPs were then educated on the usage of the OAR and completed an OAR learning module. In phase 2, NPPs applied the OAR to 184 included patients.ResultsThe sensitivity of the foot rule, as applied by NPP’s, was 100% (56-100% CI) and the specificity was 17% (9-29% CI) for clinically significant fractures. The sensitivity of the ankle portion of the rule, as applied by NPP’s, was 88% (47-99 CI) and the specificity was 31% (23-40% CI) for clinically significant fractures. The only clinically significant fracture missed by NPP’s was detected on physician assessment. Inter-observer agreement was κ=0.24 for the ankle rule and κ=0.49 for the foot rule.ConclusionThe sensitivity of the OAR when applied by NPP’s was very good. More training and practice using the OAR would likely improve NPP’s inter-observer reliability. Our data suggest the OAR may be a useful tool for NPP’s to apply prior to physician assessment.

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