CH6 : Ottawa Ankle Rules
Is there a way to check by yourself if there is a fracture?
Usually when we sprain our ankle, our first instinct is to go see a doctor at the emergency. After all, the emergency doctor would be able to give us an X-ray and direct us to the appropriate resources.
Common injuries are ligament tears on the outer side of the ankle, as well as fractures in the ankle or foot. In the case of ligament tears, the diagnosis is normally done through an examination by hand and not with x-rays, since x-ray images can only reveal bones. Then all these cases are sent directly to physiotherapy.
In the case of fractures, the diagnosis can be done through an X-ray, which was the only way of doing things until the creation of the Ottawa Ankle Rules in 1992. These Rules, which were formulated by researchers and emergency doctors from the University of Ottawa, consist of a series of questions that help determine if the patient has a fracture.
In summary, if the patient fails one of the questions, there could be a fracture and an x-ray will be administered just in case. On the other hand, if the patient answers favorably to all the questions, there is very little chance that there is a fracture. Therefore, the X-ray will be deemed unnecessary and the patient will be sent to physiotherapy.
People familiar with the Ottawa Ankle Rules include emergency doctors, family doctors, and physiotherapists, but the Rules are easy enough for the patient to learn and self-administer when the time comes.
In short, the good news is that there exists a test that you can self-administer to rule out a fracture, potentially saving you from a time-consuming trip to the emergency, and potentially helping you avoid unnecessary radiation exposure. If you want to learn these famous Rules, do not hesitate to ask your physiotherapist!