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Practice Quality Improvement Report

A multifaceted strategy for implementation of the Ottawa ankle rules in two emergency departments

BMJ 2009; 339 doi: https://doi.org/10.1136/bmj.b3056 (Published 12 August 2009) Cite this as: BMJ 2009;339:b3056

Rapid Response:

Are Ottawa ankle rules really valid?

Sir, I would like to point out form personal experience that I have
doubts about the Ottawa ankle rules and do not rely on them. Following a
fall while skiing I suffered an ankle injury. I was assessed by several
medical collegues, all applying the Ottawa rules, and deemed not to
require an x-ray. To validate my insurance I saw an independant doctor
who also assessed using the rules and was confidently diagnosed with a
sprain. 2 weeks later with ongoing pains an x-ray confirmed a spiral
fracture of the distal fibula. Can we really rely on these rules?

Competing interests:
None declared

Competing interests: No competing interests

18 August 2009
David W Jones
GP
Pheonix surgery TR14 7DL