Ayak bileği travmalı hastalarda rutin grafi gerekliliğinin Ottawa kuralları ile değerlendirilmesi

Aims: The aim of this study is to evaluate the effectiveness of Ottawa ankle rules (OAR) by means of reducing the unnecessary radiographic examinations demanded in the emergency service patients. Material and method: One hundred and fifty patients who were admitted to the emergency service, between November 2012 and February 2013, due to ankle injury, were included in the study. The demanded radiographical evaluations were decided according to OAR. Lauge-Hansen classification was made to evaluate the trauma mechanism in the patients. The sensitivity, the specificity, positive and negative predictive values of OAR were defined and the feasibility was evaluated. Results: The mean age was 32 (range 16-68) years. Eighty two (55 %) of the patients were male and 68 (45 %) of the patients were female. There were fractures in 38 (25,3) patients. Of these fractures 33 of them were in the malleolar and distal tibial region, whereas 5 of them were in the foot. Six of the fractures were classified as supination-adduction type, 21 of the fractures were supination- external rotation type, 8 of the fractures were pronation-abduction type and 3 of the fractures were pronation-external rotation type. The sensitivity of OAK was found as 94,7 % and specificity was found as 69,6%. The positive predictive value was 51,4 % and the negative predictive value was 97,5 %. Conclusion: Ottawa ankle rules are easy to apply and effective in decision making. Also we suggest that the elimination of the legal issues while the rules are applied may increase the feasibility and usefulness.