Ankle Dislocation in Emergency Medicine Guidelines

Updated: Apr 29, 2016
  • Author: James E Keany, MD, FACEP; Chief Editor: Trevor John Mills, MD, MPH  more...
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Guidelines

Guidelines Summary

The Ottawa Ankle Rules, originally developed by Stiell and colleagues, provides a clinical decision approach to guide the assessment of ankle injuries, particularly to determine the need for radiography in emergency departments. [13, 14]

The ACR Appropriateness Criteria for acute trauma to the ankle for adults and children older than 5 years notes 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 inferior tip of the lateral malleolus or talus or calcaneus, OR (3) inability to ambulate for 4 steps in the ED. [15]