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ISSN 0185-3252 (Print)
Revista de la Asociación Médica del Centro Médico ABC

2008, Number 1

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An Med Asoc Med Hosp ABC 2008; 53 (1)

Comparative analysis of the criteria used in the Emergency Departament of the ABC Medical Center with respect to the Ottawa Ankle Rules in ordering ankle and foot radiographs

Romo RR, Velutini KJA, Orrico GRD, Quinzaños FJ

Language: Spanish
References: 22
Page: 15-21
PDF size: 129.96 Kb.


ABSTRACT

The Ottawa ankle rules are widely used in emergency departments around the world to clinically identify ankle and midfoot fractures guiding the need for radiographs. They have proved to have 100% sensitivity and 100% negative predictive value. The use of these rules has reduced the cost of the medical service and the waiting time in the emergency departments without diminishing the quality of the medical service. In this study, we compared the amount of foot and ankle radiographies taken in the Emergency Department of the ABC Medical Center with those taken according to the Ottawa ankle rules. Fifty-four patients were included, 49 radiographs were taken and 9 fractures were found. If the Ottawa ankle rules had been applied, only half of the patients would have been submitted to radiographs identifying the 9 fractures. The sensitivity and the negative predictive value were 100% for both of the criteria but the specificity and the PPV were lower for the criteria of the ABC Medical Center with 11% and 18% with respect to the Ottawa ankle rules with 60% and 33%. (p ‹ 0.001). If the Ottawa ankle rules had been applied, there would have been a decrease in the cost and waiting time for 22 of the 54 patients without reducing the quality of the medical service.


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