Clinical usefulness of the Ottawa Ankle Rules for detecting fractures of the ankle and midfoot.

Biokinetics Research Laboratory, Department of Kinesiology, Temple University, Philadelphia, PA 19122, USA.
Journal of athletic training (Impact Factor: 1.51). 09/2010; 45(5):480-2. DOI: 10.4085/1062-6050-45.5.480
Source: PubMed
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    ABSTRACT: Authors' contributions Authors CA and MSY designed the study, performed the statistical analysis, wrote the protocol, and wrote the first draft of the manuscript. Authors CK and FY managed the analyses of the study. Author MAC managed the literature searche. All authors read and approved the final manuscript. ABSTRACT Aim: This study was a prospective validation of the Ottawa Ankle Rules (OAR) in our patient population with ankle injury. Materials and Methods: This was a prospective study conducted. Each patient's demographic characteristics, radiography results, and status of meeting OAR criteria were recorded on a previously prepared study form. The descriptive statistics were presented as Mean, Standard Deviation, and percentage. Categorical variables were analyzed using Chi-Square test. The correlation between OAR positivity and presence of a fracture was analyzed using the Spearman's correlation analysis. Results: The sensitivity of OAR was 100%, specificity 27%, negative predictive value 100%, and the positive predictive value 17%. Conclusion: A careful physical examination and use of OAR may allow avoiding unnecessary tests.
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    ABSTRACT: Background:Foot and ankle injuries are frequent in emergency departments. Although only a few patients with foot and ankle sprain present fractures and the fracture patterns are almost always simple, lack of fracture diagnosis can lead to poor functional outcomes.Aim:The present study aims to evaluate the reliability of the Ottawa ankle rules and the orthopedic surgeon subjective perception to assess foot and ankle fractures after sprains.Subjects and Methods:A cross-sectional study was conducted from July 2012 to December 2012. Ethical approval was granted. Two hundred seventy-four adult patients admitted to the emergency department with foot and/or ankle sprain were evaluated by an orthopedic surgeon who completed a questionnaire prior to radiographic assessment. The Ottawa ankle rules and subjective perception of foot and/or ankle fractures were evaluated on the questionnaire.Results:Thirteen percent (36/274) patients presented fracture. Orthopedic surgeon subjective analysis showed 55.6% sensitivity, 90.1% specificity, 46.5% positive predictive value and 92.9% negative predictive value. The general orthopedic surgeon opinion accuracy was 85.4%. The Ottawa ankle rules presented 97.2% sensitivity, 7.8% specificity, 13.9% positive predictive value, 95% negative predictive value and 19.9% accuracy respectively. Weight-bearing inability was the Ottawa ankle rule item that presented the highest reliability, 69.4% sensitivity, 61.6% specificity, 63.1% accuracy, 21.9% positive predictive value and 93% negative predictive value respectively.Conclusion:The Ottawa ankle rules showed high reliability for deciding when to take radiographs in foot and/or ankle sprains. Weight-bearing inability was the most important isolated item to predict fracture presence. Orthopedic surgeon subjective analysis to predict fracture possibility showed a high specificity rate, representing a confident method to exclude unnecessary radiographic exams.
    05/2014; 4(3):432-5. DOI:10.4103/2141-9248.133473
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    ABSTRACT: BACKGROUND: The aim of this study was to suggest a safe management method for the diagnosis and treatment of ankle sprains in pregnant patients. METHODS: Between November 2005 and January 2013, 96 pregnant patients with ankle sprains referred to the department of orthopedics and traumatology were evaluated, retrospectively. The Ottawa ankle rules were used to assess the need for radiologic evaluation. Radiological procedures: Surface USG, X-ray (0,6 mGy, mortise view), MRI (TI and STIR) and fluoroscopy with 0,8 mGy/s doses 0,4 ms single shot views in surgery room. The results of the operated patients were evaluated with AOFAS scoring system. RESULTS: Forty-four (%45,8) patients were treated with conservative methods and there was no need for radiological evaluation. USG was used in 17 (%17,7), MRI in 24 (%25), X-ray in 4 (%4, 1) and both USG and MRI in 7 (%7,2) patients during diagnosis. An algorithm was created for the diagnosis and treatment of pregnant patients with ankle sprains. No complications due to radiological and surgical procedures occurred over pregnancies. The AOFAS score was 83 (65-100) in the operated patients. CONCLUSION: There is no standard management method for the diagnosis and treatment of pregnant patients with ankle sprains. The algorithm presented in this study may be useful. Good results can be obtained with an appropriate preparation and surgical technique.
    Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery: TJTES 07/2014; 20(4):275-80. DOI:10.5505/tjtes.2014.94914 · 0.38 Impact Factor


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