Published 7 August 2009, doi:10.1136/bmj.b2901
Cite this as: BMJ 2009;339:b2901

Practice

Diagnosis in General Practice

The injured ankle and foot

¹ Albany Medical College, Albany, NY, USA

In this pair of articles, Gavin Falk and Tom Fahey (doi:10.1136/bmj.b2899) set out what to consider when using a clinical prediction rule, and Dan Mayer (doi:10.1136/bmj.b2901) shows how one such rule, the Ottawa ankle rules, is applied

The first 150 words of the full text of this article appear below.

While playing basketball, a 26 year old student went up for a shot and came down inverting his ankle. He heard a loud pop and felt severe ankle pain. He was unable to get up for a few minutes, but his friends helped him up and he was able to limp off the court. He saw his primary care physician the next day, limping badly.

Injuries to the ankle and mid-foot are commonly seen in primary care and hospital emergency departments. Only 15% of these are fractures,¹ and the diagnostic dilemma for the clinician is thus to identify patients with such fractures, as these require plaster immobilisation or referral to an orthopaedic specialist. Most other injuries are treated for ligamentous stretch or disruption with dynamic stabilisation, rest, and physical therapy.

In the past, the decision making process for ankle and mid-foot injuries involved subjective elements of the history and physical . . . [Full text of this article]

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    StumbleUpon    Technorati    What's this?

Relevant Articles

Rules are different in diabetes

Anthony P Coll
BMJ 2009 339: b3507. [Extract] [Full Text]

How to avoid unnecessary interventions

Fiona Godlee
BMJ 2009 339: b3304. [Extract] [Full Text]

Clinical prediction rules

Gavin Falk and Tom Fahey
BMJ 2009 339: b2899. [Extract] [Full Text]

The injured ankle and foot

Dan Mayer
BMJ 2009 339: b2901. [Extract] [Full Text]

Accuracy of Ottawa ankle rules to exclude fractures of the ankle and mid-foot: systematic review

Lucas M Bachmann, Esther Kolb, Michael T Koller, Johann Steurer, and Gerben ter Riet
BMJ 2003 326: 417. [Abstract] [Full Text] [PDF]

Multicentre trial to introduce the Ottawa ankle rules for use of radiography in acute ankle injuries

Ian Stiell, George Wells, Andreas Laupacis, Robert Brison, Richard Verbeek, Katherine Vandemheen, and C David Naylor
BMJ 1995 311: 594-597. [Abstract] [Full Text]

This article has been cited by other articles:

• Coll, A. P (2009). Rules are different in diabetes. BMJ 339: b3507-b3507 [Full text]  

Rapid Responses:

Read all Rapid Responses

Different rules for diabetic feet.

Anthony P Coll
bmj.com, 17 Aug 2009 [Full text]

Erratum - credo

Wilfrid Treasure
bmj.com, 18 Aug 2009 [Full text]

Online poll

Find out more here>> and here>>