File Name: ottawa ankle and foot rules .zip
Introduction: The Ottawa ankle rules OAR is a tool physicians may use to determine whether or not to perform an x-ray after an ankle or midfoot distortion or blunt trauma to these structures. The rationale of using the OAR is to exclude a fracture by means of clinical examination without resort to x-rays, and thereby limiting the use of x-rays, time, costs, etc. The principle of the OAR is that an ankle x-ray is only required when there is bone tenderness along the distal six centimetres of the posterior part of the medial or lateral malleolus, or when the patient is unable to bear weight immediately after the accident and in the emergency department ED.
Ankle and foot injuries are common presentations to the Emergency Department, and it can often be difficult to know whether imaging is required. In , Dr. The Ottawa ankle and foot rules are highly sensitive and widely used as a tool to reduce unnecessary imaging in Emergency Departments. The rules are as follows: An ankle radiographic series is only required if there is any pain in the malleolar zone and any of these findings:. A foot radiographic series is only required if there is any pain in the midfoot zone and any of these findings:. Show them how slick you are, When you check the navicular. This Tiny Tips piece on how to remember the Ottawa Ankle rules is super helpful and very accurate.
In medicine , the Ottawa ankle rules are a set of guidelines for clinicians to help decide if a patient with foot or ankle pain should be offered X-rays to diagnose a possible bone fracture. Before the introduction of the rules most patients with ankle injuries would have been imaged. However the vast majority of patients with unclear ankle injuries do not have bone fractures. Additionally, the Ottawa ankle rules indicate whether a foot X-ray series is required. It states that it is indicated if:. Certain groups are excluded, in particular pregnant women, and those with diminished ability to follow the test for example due to head injury or intoxication. Several studies strongly support the use of the Ottawa Ankle Rules in children over 6
J Am Osteopath Assoc ; 12 — Context: Reducing unnecessary testing lessens the cost burden of medical care, but decreasing use depends on consistently following evidence-based clinical decision rules. The Ottawa foot and ankle rules OFARs are validated, longstanding evidence-based guidelines to predict fractures. Frequently, radiography is automatically ordered for acute ankle injuries despite findings from OFARs suggesting no fracture. Objectives: First, to determine whether implementation of protocol-driven use of the OFARs at triage would decrease the number of radiography orders and length of stay LOS in the emergency department.
Enter your email address and we'll send you a link to reset your password. The Ottawa Ankle Rule was derived to aid efficient use of radiography in acute ankle and midfoot injuries. Please fill out required fields. Why did you develop the Ottawa Ankle Rule? Was there a clinical experience that inspired you to create this rule for clinicians? We found that emergency doctors were ordering many imaging studies for ankle injuries that were then found to be normal. I thought if there were a set a rules with criteria developed by emergency physicians, for emergency physicians, they would help this problem and shorten emergency department wait times and costs.
Main Outcome Measure. The rules were found to have sensitivities of 1. In the following 12 months at the intervention hospital, use of radiography did not increase. Future studies should address the generalizability of these decision rules in a variety of hospital settings. Implementation of the Ottawa Ankle Rules. Coronavirus Resource Center.
The Ottawa ankle rules OAR are clinical decision guidelines used to identify whether patients with ankle injuries need to undergo radiography. The OAR have been proven that their application reduces unnecessary radiography. They have nearly perfect sensitivity for identifying clinically significant ankle fractures. The purpose of this study was to assess the applicability of the OAR in China, to examine their accuracy for the diagnosis of fractures in patients with acute ankle sprains, and to assess their clinical utility for the detection of occult fractures.