The evaluation of the Ottawa ankle rule in diagnosis af acute injuries by radiography in the ED of HAZRAT RASOOL MEDICAL COMPLEX

Acute ankleinjury aeramong the most frequent presentation complaints in emergency departments . most ankle injury patient undergo radiography, whereas onlyn asmall portion of them have significant fractures of avulsion fractures, rationalizing the use of ankle radiography may reduce ED waiting time,excessive radiation foe patient ans direct costs of radiography for the health care system, steill et al developned clinical prediction rules (termed ottawa ankle relues) and declared that by these rules the number of ankle and midfoot radiographies needed reduces to 1/3 with a sensitivity of 100%. This study is assesing the sensitivity and specificitry of these rules in our country which has never been done in IRAN .inthis prospective cohort survey which was conducted in the ED of HAZRAT RASOOL MEDICAL COMPLEX, the study group consisted of 276 consecutive patients aged 18years and older was presented with acute ankle and midfoot injuries in the ED during four months period and met the given criteria. Radiography was performed in each patienr after clinical avaluation findings were recorded. The study group compromised 151 men & 125 wemon. 91.7% of palienls has presented to thc ED in the first day of injury. The most frequent types of injury were sprain (41.3%) and soft tissue injury(27.5%), respecti vely the most frequnt mechanism of injury was inversion (41.3%) followed by cversion (26.87c).ln 199 cases the radiographic findings were nurmal. .thity six ankle fracture were diagnosed (9.13%) which all of them met the eules' criteria in another word. The rules didnil fail to predict any ankle fracture. Of 240 patients without any fracture,101 met the rules criteria and the remaining 139 didn't meet. The decision rules had a sensitivity of 100% and a specificity of 58%, negative predictive value of 100% and pelsitive predictive value of 26% Application of the Ottawa arikle rule by emergency physicians resulted in 100% sensitivity and would have reducedankle radiography requested by 13%.