CPR for Ankle Fracture
Ottawa Ankle Rules for excluding ankle and mid-foot fractures
Does the patient have:
- Inability to walk 4 steps immediately after an injury
- Localized tenderness of the posterior edge or tip of either malleoli
- Localized tenderness of the navicular bone or base of 5th metarsal
If they have either of 1-3 in addition to “pain in the midfoot or ankle”, they should be referred for an x-ray
Sensativity: 100%
Specificity:26-48%
Bachmann LM, Kolb E, Koller MT, et al. Accuracy of Ottawa ankle rules to exclude fractures of the ankle and mid-foot: systematic review.British Medical Journal; 326: 417-19.
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what about the nausea, shock and tremors, bruising and swelling? These symptoms are more telling of an acute fracture than “tenderness” and weight-bearing (ie. distal fibula could be missed as it is a non-weight-bearing bone)
Thanks for the comment Katherine…While there are alot of consistent signs and symptoms associated with ankle fractures, this set of criteria has been found statically to be a good screening guide for us to determine who likely has a fracture and needs an x-ray. That stated, many other criteria are often involved but these 3 items are the most consistent in the literature..In the end, if you believe someone has a fracture, get the x-ray…
This is so helpful. I just completed my semester on Diagnostic Imaging. Your site is very helpful. I am going to link it to mine http://www.Ardentpt.com.
Thank you ,
Sweta