Скачать или смотреть The Ottawa Ankle Rules | Ankle Fracture Clinical Prediction Rule

If the Ottawa ankle rules are negative, chances of a fracture are low.
Now, let's imagine the following situation: You are a physiotherapist at a sporting event, and you see an athlete getting injured at the ankle.
You can use the following sequence to rule out an ankle fracture. First, palpate for tenderness on the posterior edge of the lateral and medial malleoli. Start distally and move 6 centimeters upwards.
Then, palpate for pain or tenderness over the navicular bone and the 5th metatarsal. For the last criterion, ask the patient to walk four consecutive steps. It doesn't matter how the patient is walking; he might as well be limping.
Now, if one out of three items is positive, there is a 25 to 50 percent chance that there is a fracture. The patient should then get X-rays done. But if all three items are negative, there is close to a 100 percent chance of no fracture at all.

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