Prospective survey to verify the Ottawa ankle rules.

OBJECTIVE To determine if the Ottawa ankle rules are valid in the setting of an urban teaching hospital in the UK. DESIGN A prospective survey. SETTING Accident and emergency department, Western Infirmary, Glasgow from 1 April 1995 to 31 August 1995. SUBJECTS 800 patients with an acute ankle injury. RESULTS 800 patients were used for analysis of which 584 (73%) were radiographed; 70 (12%) had fractures, 63 (10.8%) of which were significant. Four of these patients with fractures fulfilled none of the Ottawa ankle rules criteria for plain radiography. CONCLUSION Application of the Ottawa ankle rules to this group of patients would have produced a sensitivity of 93.6%. Although useful, decision rules should be used with care and not replace clinical judgment and experience.