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Comparison of Ottawa Ankle Rules and Bernese Ankle Rules in Acute Ankle and Midfoot Injuries

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Author(s): Ozkan KOSE | Servan GOKHAN | Ayhan OZHASENEKLER | Mustafa CELIKTAS | Seyhmus YIGIT | Serkan GURCAN

Journal: Turkish Journal of Emergency Medicine
ISSN 1304-7361

Volume: 10;
Issue: 3;
Start page: 101;
Date: 2010;
Original page

Keywords: Ankle | Bernese Ankle Rules | foot | fracture | Ottawa Ankle Rules.

ABSTRACT
Objective: The purpose of this study was to compare the sensitivity and specificity of Ottawa Ankle Rules (OAR) and Bernese Ankle Rules (BAR) in acute ankle and midfoot injuries in the emergency department. Methods: 100 consecutive patients presented to our emergency department with acute ankle and/or midfoot injuries following a blunt trauma were included. Patients were physically examined and evaluated regarding the BAR and OAR respectively by the same emergency medicine physician. All patients were referred for standard radiography of the ankle or foot or both according to the presence of pain or tenderness in one or both of these zones. Radiography results were interpreted by a consultant orthopedic surgeon who had not examined the patients. Sensitivity, specificity, positive and negative predictive values of each test were calculated. Results: Radiographic examinations showed 19 fractures out of 100 investigated patients. Sensitivity and specificity of OAR were 100% and 77% respectively. Sensitivity and specificity of BAR were 94% and 95% respectively. Positive and negative predictive values of OAR were 51% and 100% respectively while positive and negative predictive value of BAR found to be 81% and 98% respectively. Conclusions: This study showed that OAR has better sensitivity than BAR. However, BAR has better specificity than OAR. Although BAR has better specificity, we still suggest use of OAR due to its 100% sensitivity.
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