Purpose: The Ottawa Ankle Rules were developed in order to determine the need for radiographs after acute ankle injury secondary to the risk of fracture.
Rule:
Pain in malleolar or midfoot area and Either:
1. Inability to bear weight immediately after injury AND in the ED (taking 4 steps)
OR
2. Bone tenderness at the posterior edge of tibia or fibula or tip of medial or lateral malleolus
3. Bone tenderness at the navicular or proximal base of 5th metatarsal
Interpretation:
| Region | Sensitivity | Specificity | +LR | -LR |
| Ankle | 0.99 | 0.35 | 1.53 | 0.02 |
| Midfoot | 0.99 | 0.42 | 1.72 | 0.02 |
| Ankle & Midfoot | 0.97 | 0.35 | 1.48 | 0.09 |
Research:
1. Beckenkamp PR, Lin C-WC, Macaskill P, Michaleff ZA, Maher CG, Moseley AM. Diagnostic accuracy of the Ottawa Ankle and Midfoot Rules: a systematic review with meta-analysis. British Journal of Sports Medicine. 2017; 51(6): 504-510. doi:10.1136/bjsports-2016-096858.
Continued Learning…
Continued Reading…
John Snyder, DPT 