Ottawa Rule | The University Of Western Ontario - Edubirdie

University:
The University Of Western Ontario
Course:
Biology 2290F | Scientific Method in Biology
Academic year:

2022
Views:

177

Pages:

3
Author:

Kyuwon J.

Ottawa rule ● Used to rule out fractures ● Reduce unnecessary ankle + foot X-rays Ankle X-ray Required when… ● Bone tenderness on posterior edge + tip of Lateral Malleolus ● Bone tenderness on posterior edge + tip of Medial MAlleoulus ● Cannot bear weight right away due to injury in EM ○ Unable to take 4 steps ● Pain in alveolar zone Foot X-ray Required when… ● Bone tenderness on base of 5th Metatarsals ● Bone tenderness on Navicular bone ● Inability on bearing weight immediately ● Pain in Midfoot zone Ottawa knee rules ● Clinical decision making tool where patients with acute knee injury requiring knee X-ray to find whether they have fracture or not ● Near 100% sensitivity on detecting clinically significant fractures ● Reliable on ruling out fractures if none are met ○ Reduce unnecessary imaging cost ● Knee X-ray indicates if patient have acute knee injury (injury within 7 day) ○ Typically AP ○ Lateral ○ Merchant view ● For patient to be in acute injury phase they must meet one of the following criteria ○ Age ■ Greater than 55 year ● Due to increased risk of fragility fracture ● Reduced bone mineral density ○ Isolated tenderness of patella ■ Bone tenderness localized over patella ■ Only over patella but no where else ● Tibial plateau, femoral condyles ■ Tenderness should be elicited by palpation of patella itself ● Not peripatellar soft tissues ○ Tenderness on head of fibula ■ Bone tenderness upon palpation of fibular head ■ Common site of fractures with association of ligament injury ○ Inability on flexing knee in 90 degree ■ Active/passive inability = significant mechanical derangement+effusion ■ Need future investigations ○ Inability on Bearing Weight ■ Unable to transfer weight onto the inured leg ● Immediately after injury ● Clinic ● Contradictions/ limitations ○ Ottawa knee rules are not applicable in some cases ■ Multiple distracting injuries ● Patient with knee injury AND severe hip and ankle pain ■ Alteration on level of consciousness ● Head injury ■ Spinal immobilization ■ Prior injury in same location ● Same knee ■ Pregnancy ■ After 7 day period after injury ● The injury is now sub-acute or chronic

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