O1281 THE NEED OF X-RAYS IN FOOT AND ANKLE INJURIES: OTTAWA ANKLE RULES IN EMERGENCY DEPARTMENT. A FOLLOW-UP OF 124 PATIENTS

Abstract

Aims: To validate the use Ottawa Ankles Rules (OAR) protocol in the accidents department, to evaluate its sensitivity in excluding a fracture and to examine the practical benefits. Methods: From August 2000 to January 2001 we examined 124 patients with foot and ankle injuries in the A& E department by three of our junior doctors. They were judged according to OAR protocol which requests an x-ray according to certain criteria. We have estimated the time spent in A& E. 72 of them were in accordance of the OAR protocol and they had typical x-ray examination & subsequent treatment. Results: The remaining 52 (41.9%) patients consist the target population. They were reexamined in 48–72 h, in one week and in one month and there was no need for an x-ray to any of them. None of them had a second opinion & they followed the given orders. The target group stayed for an average of 8.8 min (SD=4.4), while the other group for 24.6 min (SD=10.8), which was statistical significant (p< 0.001). From the above is obvious a 100% sensitivity of the method & so decrease in the amount of x-rays by 41.9%.

Conclusions: It is apparent that this protocol can be safely introduced in the A& E department. It has to be used by orthopaedic surgeons (trainees) with appropriate behavior & respect to the patient. It can diminish the number of x-rays, the amount of radiation, the cost and the waiting time in the A& E department.