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Review: the Ottawa Ankle rules are accurate for excluding fractures in acute blunt ankle/midfoot injury in children

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Questions

In children, are the Ottawa Ankle Rules (OAR) accurate for excluding fractures of the ankle and midfoot? Can ankle/foot x rays be reduced without missing important fractures?

Review scope

Included studies used the OAR to diagnose fractures of the ankle or midfoot in children (⩽18 y) who presented to the emergency department with acute blunt ankle and/or midfoot injury, and reported absolute numbers for comparing the OAR with the diagnostic standard (x rays of ankle/foot or proxy measure, such as telephone follow-up at 14 d). Toddlers must have begun walking before injury. Outcomes were sensitivity, specificity, and likelihood ratios (LRs) to detect fracture, and x ray reduction rates.

Review methods

Medline, CINAHL, EMBASE/Excerpta Medica, Cochrane Central Register of Controlled Trials, National Library of Medicine Gateway, and BioMed Central (all …

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