Gr. Auleley et al., VALIDATION OF THE OTTAWA ANKLE RULES IN FRANCE - A STUDY IN THE SURGICAL EMERGENCY DEPARTMENT OF A TEACHING HOSPITAL, Annals of emergency medicine, 32(1), 1998, pp. 14-18
Study objective: To validate the Ottawa ankle rules to predict fractur
es in a French clinical setting when they are used by physicians not i
nvolved in their development. Methods: We used a prospective patient s
urvey by emergency physicians in a surgical emergency department of a
university teaching hospital of the Assistance Publique-Hopitaux de Pa
ris. The study group consisted of 416 consecutive patients aged 18 yea
rs and older who presented with acute ankle or midfoot injuries in the
surgical ED during a if-month period. Radiography was performed in ea
ch patient after clinical evaluation findings were recorded. Results:
Forty-nine ankle and 22 midfoot fractures were diagnosed. The decision
rules had a sensitivity of.98, a specificity of.45, and a negative pr
edictive value of.99 in detecting ankle fractures, a sensitivity of 1.
0, a specificity of.29, and a negative predictive Value of 1.0 in dete
cting midfoot fractures. The rules failed to predict one avulsion frac
ture in the ankle group. Application of these rules by emergency physi
cians would have reduced ankle or midfoot radiography requests by 33%.
Conclusion: Use of the Ottawa ankle rules by French emergency physici
ans not involved in the rules' development resulted in 99% sensitivity
and had a potential of reducing radiography requests by 33%.