Diagnosi di frattura della caviglia prima della radiografia con le regole di Ottawa

Aim. It is not infrequent to have to treat patients with ankle injuries. Fractures, however, are only found in 15-20% of such cases, so X-ray is often pointless not to say damaging. A study by Dr. Stiell has set out the so-called Ottawa rules to help the physician to suspect ankle fracture prior to X-ray. The purpose of this paper is to investigate whether, in our Emergency Department experience, X-rays could have been avoided by applying the Ottawa rules. Methods. Over a period of about 15 months we examined 48 patients suffering from acute ankle injuries. All were given X-rays. Results. Thirteen patients responded positively to the Ottawa rules and in 11 of them a fracture was in fact encountered. The remaining 35 did not respond to the Ottawa rules and did not Present a fracture. Conclusion. Our experience leads us to believe that the Ottawa rules are a useful instrument for excluding ankle fracture before carrying out X-ray.