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| www.smw.ch |
| Can Ü, Ruckert R, Held U, Buchmann P, Platz A, Bachmann LM. |
Swiss Med Wkly 2008;138:292–296
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| Original article Peer reviewed article |
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| Objectives: We examined the
accuracy of the Ottawa Ankle Rule (OAR) to rule out ankle and mid-foot fractures
in patients presenting with acute ankle sprain and differences of accuracy
between surgeons and non-surgeons. Design: prospective cohort study. Setting: Swiss urban secondary care centre. Participants: Between September 2001 and October 2002 359 patients presented with a case of ankle sprain. Of these, 251 patients both met recruitment criteria and provided data for this study. A group of surgeons and non-surgeons assessed the OAR and all patients underwent blinded radiographic assessment. Main outcome measures: Sensitivity, specificity of the OAR. Results: Of the 251 patients with ankle sprains 33 had an ankle fracture (13%) and none had a mid-foot fracture. All cases with a fracture had a positive OAR result (sensitivity 100% 95% CI; 89–100) and of 218 patients without a fracture, the OAR was negative in 45 cases (specificity 21%; 16–27). In the subgroup of patients assessed by surgeons, sensitivity was 100% (77–100) and specificity was 32% (20–46). In the non-surgical group, sensitivity was also 100% (82–100) but specificity was lower (17% (11–23). Conclusions: This validation study of the OAR in a Swiss setting produced similar results than those published previously in various other settings. We found differences in the performance of the rule between surgical and non-surgical staff indicating that the OAR has its interpretation component which is more difficult to judge properly by well-instructed non-surgical assessors. |
Surgical Clinic, Stadtspital Triemli, Zürich Surgical Clinic, Stadtspital Waid, Zürich Horten Centre for patient oriented research, University of Zurich, Zurich, Switzerland |
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Copyright © 2008 EMH Swiss Medical Publishers Ltd. |
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