quick reference
Sprains
Ottawa Ankle Rule
Patients ≥2 years old with ankle or midfoot pain/tenderness in the setting of trauma.
Ottawa Ankle Rule
Exceptions
- Age <6 or >55
- Only for blunt trauma mechanism
- Does not apply to subacute/chronic injuries
- Does not apply to injuries of the hindfoot or forefoot
Fracture
pathophysiology / anatomy
epidemiology / etiology
clinical features
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If ankle pain is present and there is tenderness over the posterior 6 cm or tip of the lateral or medial malleolus, then ankle x-ray is indicated.
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If midfoot pain is present and there is tenderness over the navicular or the base of the fifth metatarsal, then foot x-ray is indicated
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If there is ankle or midfoot pain and the patient is unable to take four steps both immediately and in the emergency department, then x-ray of the painful area is indicated.