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—We were very interested to hear of the rather novel and innovative application of the Ottawa ankle rules by Drs McCarter and Slawson. Although the rules were applied in a fashion for which they were not intended (ie, by telephone and for a child), we recognize the exceptional circumstances of their use.While the Ottawa ankle rules have been shown to be reliable and effective for reducing the use of radiography in adults, we wish to remind readers that they have not yet been validated for patients younger than 18 years.
Stiell IG. Clinical Application of the Ottawa Ankle Rules-Reply. JAMA. 1994;272(7):518. doi:10.1001/jama.1994.03520070036032