Ottawa Ankle Rule
Xray after blunt ankle trauma?
Obtain an ankle xray if there is pain near the malleoli and one of the following:
- Bone tenderness is present at the posterior edge of the distal 6 cm or the tip of either
malleolus.
- The patient is unable to bear weight for at least four steps immediately after the injury and
at the time of evaluation.
Obtain a foot xray if there is pain in the midfoot and one of the following:
- Bone tenderness is present at the navicular or the base of the fifth metatarsal.
- The patient is unable to bear weight for at least four steps immediately after the injury and
at the time of evaluation.
Blunt ankle trauma includes twisting injuries, falls, and direct blows.