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CHAPTER 65 THE OTTAWA ANKLE RULES
Decision Rules for the Use of Radiography in Acute Ankle Injuries. Refinement and Prospective Validation
Stiell IG, Greenberg GH, McKnight RD, et al. JAMA. 1993;269(9):1127–1132
BACKGROUND
Ankle injuries are a common presenting complaint in the ED and radiographs of the ankle are among the most commonly ordered radiographic studies. However, the overall fracture rate is less than 15%. Prior to this study, an accepted and validated clinical decision rule did not exist to help determine which patients were at a high risk of fracture, and should receive radiographs.
OBJECTIVE
To refine and validate a previously developed decision rule for obtaining ankle radiographs in acute ankle injuries.
METHODS
Two-stage, prospective, multicenter observational validation study in two Canadian academic EDs between 1991 and 1992. In the first stage, a previously derived decision rule was validated and refined. In the second stage, the refined rule was prospectively validated.
Patients
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