Validation of the Ottawa ankle rules in a Hong Kong ED

The Ottawa ankle rules (OAR) have been validated in many Western countries. However, a recent study performed in an accident and emergency department in Singapore failed to validate the OAR. Therefore, the implementation of the use of OAR in accident and emergency departments in Hong Kong may be treated with skepticism. This prospective study was performed to validate the ordering of radiographs using OAR in Chinese patients with foot and ankle injuries in Hong Kong. Emergency physicians trained in the use of the OAR assessed 773 eligible patients and one hundred thirty-one fractures were identified. The sensitivity and specificity of the OAR for ankle injuries was 98% and 40.8%. For midfoot injuries, the sensitivity and specificity of the OAR was 100% and 43.8%. We concluded that the OAR are applicable in our population with potential advantages for reducing the number of unnecessary investigations and shortening the patients' length of stay in accident and emergency departments.