[Application of the Ottawa ankle rules in the ankle and midfoot injuries: verification of the method on the basis of own material].

The aim of study was to verify the specificity and usefulness of the Ottawa Ankle Rules in trauma patients. Prospective observations were made on 103 adult patients (48 males and 55 females aged 16 to 74 years). Clinical examination was subsequently verified by radiography. According to Ottawa Rules pain in the posterior aspect of distal 6 cm of tibia or fibula or pain at fifth metatarsal or navicular bone occurring immediately after injury suggests bone fracture. In 78 cases (75%) no fracture was seen on X-ray; ankle sprain and midfoot sprain was diagnosed in 49 (63%) and 19 (37%) patients respectively. Fractures have been found in 26 patients (25%); 19 in the ankle area and 7 within tuberosity of the fifth metatarsal. Diagnosis set according to Ottawa Ankle Rules was confirmed radiologically in 89 patients (86%). Clinically diagnosed fracture was ruled out radiologically in 14 cases (13%) and only once (1%) radiogram revealed fracture missed clinically. In our material specificity of the method was 86% and the risk of misdiagnosed fracture was less than 1 percent.