In The News

Ottawa Ankle Rules Proven Close To 100% Accurate

OTTAWA, February 27, 2003 — One of the world's top medical journals is reporting the strongest validation yet that Ottawa's famous Ankle Rules can rule out ankle fractures with almost 100% accuracy and cut down on thousands of needless X-rays every year.

The Ottawa Ankle Rules, a set of guidelines that can help doctors avoid ordering unnecessary X-rays simply by observing how patients walk and by feeling their feet, were developed by a team of Ottawa researchers led by Dr. Ian Stiell, the Ottawa Hospital Research Institute Chair of Emergency Medicine Research and Professor and Head of Emergency Medicine at the University of Ottawa.

Although most patients who arrive at emergency rooms with an ankle sprain are sent for an X-ray, less than 15% actually have a fracture.

Now, a study from Switzerland and an editorial published in this week's issue of the British Medical Journal report that the Ottawa Ankle Rules have been confirmed to be nearly 100% sensitive in ruling out ankle fractures, and should reduce the number of unnecessary X-rays by 30-40%. 

Although a number of medical schools are already teaching the Ottawa Ankle Rules, and they have become part of accepted practice in many parts of the worlds, the new study should help convince even more doctors and hospitals to adopt them.

The Ankle Rules became the prototype for other "decision rules." Dr. Stiell's team has developed guidelines for knee, head and spinal injuries, rules that are transforming the way doctors assess these common injuries. Dr. Stiell's team has just received a $750,000 grant from the Canadian Institutes of Health Research to implement the Canadian C-Spine Rules in 12 hospitals across Canada. The rules can help doctors determine within minutes, instead of hours, whether an accident victim has a serious neck injury, dramatically reducing the amount of time patients have to spend in emergency strapped to a back board unable to move, and ensuring that serious injuries are not overlooked or discounted.

The ankle rules are available on the Internet for medical professions around the world to consult and use. They can be accessed at

For more information on the editorial and review published in the current issue of the British Medical Journal, visit

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Media Contacts:

Sharon Kirkey
Communications Officer
Ottawa Hospital Research Institute

Ron Vezina
Manager, Public Affairs
The Ottawa Hospital