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GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE

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Gazzetta Medica Italiana Archivio per le Scienze Mediche 2003 October;162(5):121-3

language: Italian

Ankle fracture diagnosis before X-Ray using Ottawa rules

Guglielmi V. 1, Noviello M. R. 2, Guerra V. 3, Tutino M. 4

1 Servizio Pronto Soccorso, IRCCS «S. de Bellis», Castellana Grotte (BA);
2 Servizio di Radiologia, IRCCS «S. de Bellis», Castellana Grotte (BA);
3 Laboratorio di Epidemiologia, IRCCS «S. de Bellis», Castellana Grotte (BA);
4 Centro Elaborazione Dati, IRCCS «S. de Bellis», Castellana Grotte (BA)


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Aim. It is not infrequent to have to treat patients with ankle injuries. Fractures, however, are only found in 15-20% of such cases, so X-ray is often pointless not to say damaging. A study by Dr. Stiell has set out the so-called Ottawa rules to help the physician to suspect ankle fracture prior to X-ray. The purpose of this paper is to investigate whether, in our Emergency Department experience, X-rays could have been avoided by applying the Ottawa rules.
Methods. Over a period of about 15 months we examined 48 patients suffering from acute ankle injuries. All were given X-rays.
Results. Thirteen patients responded positively to the Ottawa rules and in 11 of them a fracture was in fact encountered. The remaining 35 did not respond to the Ottawa rules and did not present a fracture.
Conclusion. Our experience leads us to believe that the Ottawa rules are a useful instrument for excluding ankle fracture before carrying out X-ray.

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