Editor,—Further to previous correspondence I think the use of the Ottawa Ankle Rule needs some clarification.¹ Firstly, the Ottawa group^{2, 3} themselves acknowledge that clinical judgement should take precedence over sticking to rigid rules. They are also careful to point out several groups in whom they do not feel the rules should be applied, such as the intoxicated, the multiply injured, or those with communication problems either because of language or mental disorder. They are very specific in stating that the entire posterior 6 cm of the maleoli should be palpated (a …