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August 17, 1994

Clinical Application of the Ottawa Ankle Rules

Author Affiliations

University of Virginia Nellysford

JAMA. 1994;272(7):518. doi:10.1001/jama.1994.03520070036031

To the Editor.  —The article on the Ottawa ankle rules by Dr Stiell and colleagues improved emergency department treatment of patients with ankle injuries.1,2 We would like to share a recent example from our own practice highlighting another potential benefit from implementing these rules.Like much of the eastern United States, we found this past January to be plagued by the worst ice storms in many years. During one particularly bad storm, one of us (D.M.) received a telephone call from the mother of a 7-year-old girl with a possible traumatic ankle fracture. This family lives on the side of a mountain accessible only via an unpaved road. To attempt to reach the child by rescue squad and then transport her 32 km to the nearest radiography facility would have been dangerous.By further questioning the mother, we were able to determine that the child had suffered an inversion

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