OBJECTIVE: To determine if the Ottawa ankle rules are valid in the setting of 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 radiographed; 70 (12%) had fractures, 63 (10.8%) of which were significant. Four of these patients with fractures fulfilled none of the Ottawa ankle rules criteria 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.
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