Ankle Dislocation Management in the ED Guidelines

Updated: Jan 26, 2022
  • Author: James E Keany, MD, FACEP; Chief Editor: Trevor John Mills, MD, MPH  more...
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Guidelines Summary

The Ottawa Ankle Rules, originally developed by Stiell and colleagues, provide a clinical decision approach to guide assessment of ankle injuries, particularly to determine the need for radiography in the emergency department. [20, 21]

The American College of Radiology (ACR) Appropriateness Criteria for acute trauma to the ankle in adults and children older than 5 years note that the Ottawa Ankle Rules recommend ankle radiographs if any of the following is present: (1) inability to bear weight immediately after the injury, OR (2) point tenderness over the medial malleolus, or the posterior edge or the inferior tip of the lateral malleolus or talus or calcaneus, OR (3) inability to ambulate 4 steps in the ED. [22]