Loading...
Please wait, while we are loading the content...
Validation of the Ottawa Ankle Rules in children with ankle injuries.
| Content Provider | Semantic Scholar |
|---|---|
| Author | Plint, Amy C. Bulloch, Blake Osmond, Martin H. Stiell, Ian G. Dunlap, Hal Reed, Martin Tenenbein, Milton Klassen, Terry P. |
| Copyright Year | 1999 |
| Abstract | OBJECTIVES The Ottawa Ankle Rules (OAR) have been found to be 100% sensitive in adult patients with ankle injuries, and application of the OAR has resulted in a 28% reduction in the number of x-rays ordered. The objectives of this study were to determine the sensitivity and specificity of the OAR in children and to determine the potential change in x-ray utilization. METHODS Children, aged 2-16 years, presenting to the EDs of two children's hospitals, with an ankle injury in the previous 48 hours, were enrolled. All patients were assessed by either staff physicians or fellows. X-rays were ordered according to standard clinical practice. Prior to reviewing x-rays, the physical examination was recorded on a standardized form. Positive outcomes (clinically significant) were defined as fractures with fragments > or =3 mm. Patients not x-rayed and asymptomatic at five to seven days postinjury were considered to have no significant fracture. RESULTS Six hundred seventy patients were enrolled. The OAR were 100% sensitive (95% CI = 95% to 100%) for significant ankle fractures, with a specificity of 24% (95% CI = 20% to 28%). The OAR were 100% sensitive (95% CI = 82% to 100%) for the midfoot, with a specificity of 36% (95% CI = 29% to 43%). If the OAR had been followed, there would have been a reduction of ankle x-rays by 16% and foot x-rays by 29% without missing any clinically significant fracture. However, analysis of the two hospitals showed that if the rules had been applied, one would have a reduction in x-rays, while the other center would have an increase. CONCLUSIONS This study demonstrates the OAR to be sensitive for detecting clinically significant (> or =3 mm) ankle and midfoot fractures in children. The application of these rules may reduce the number of x-rays ordered. A further study is required to determine the effect of using the OAR in clinical practice. |
| Starting Page | 1 |
| Ending Page | 6 |
| Page Count | 6 |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | https://medicine.stonybrookmedicine.edu/system/files/ottawa_ankle.pdf |
| PubMed reference number | 10530658v1 |
| Volume Number | 6 |
| Issue Number | 10 |
| Journal | Academic emergency medicine : official journal of the Society for Academic Emergency Medicine |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | Ankle Fractures Ankle Injuries Ankle brachial pressure index (observable entity) Cumulative Trauma Disorders Diagnostic radiologic examination Fracture Midfoot Order (action) Patients Physical Examination Plain x-ray Radiation Rajiformes Review [Publication Type] Roentgen Rays Rule (guideline) Stress Fractures |
| Content Type | Text |
| Resource Type | Article |
