Ottawa Ankle Rules
The Ottawa ankle rule is an effective tool to determine the use of radiography for acute ankle injuries.
These rules is validated in both adults and children.
It has a high sensitivity of 90%-100% and has clinical significance to rule out foot fracture but has poor specificity for ruling in foot fractures ( many false positives).
Some points to consider when carrying the assessment:
Palpate the entire distal 6cm of the fibula and tibia;
Do not neglect the importance of medial malleolar tenderness;
“Bearing weight” counts even if the patient limps;