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Ankle sprain or fracture?

Actualizado: 28 mar 2022

Ankle sprain is a frequent medical situation in emergency services. Whether practicing a sport, or / or walking in the street, at any time we can "sprain" an ankle.

The important thing is to know how to discriminate between a potential sprain or an ankle fracture.

Traditionally, an X-ray is essential to know with relative certainty. The problem is that in isolated areas, the availability of radiographs is limited.

The OTTAWA protocol was performed to reduce the use of radiographs, supported by the patient's clinic. It has 3 medullary components, within which is the palpation of certain areas of the foot and that translates into the need to take an X-ray. The interesting thing is that it also takes into account the ability to move at that time.

The protocol speaks of the following:

If the person can take 4 steps with full body weight support, radiography would not be indicated. Reduced ability to take steps is an indication of taking images.

Unfortunately, it is not a perfect tool, but it can help, especially in places where imaging is not available.

OTTAWA Protocol Validation References:

Bachmann Lucas M, Kolb Esther, Koller Michael T, Steurer Johann, Riet Gerben ter. Accuracy of Ottawa ankle rules to exclude fractures of the ankle and mid-foot: systematic review BMJ 2003; 326:417

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