Prospective survey to verify the Ottawa ankle rules

Objective-To determine if the Ottawa ankle rules are valid in the setting o f an urban teaching hospital in the UK. Design-A prospective survey Setting-Accident and emergency department, Western Infirmary; Glasgow from 1 April 1995 to 31 August 1995. Subjects-800 patients with an acute ankle injury. Results-800 patients were used for analysis of which 584 (73%) were radiogr aphed; 70 (12%) had fractures, 63 (10.8%) of which were significant. Four o f these patients with fractures fulfilled none of the Ottawa ankle rules cr iteria for plain radiography Conclusion-Application of the Ottawa ankle rules to this group of patients would have produced a sensitivity of 93.6%. Although useful, decision rules should be used with care and not replace clinical judgment and experience.