ASSESSMENT OF OTTAWA ANKLE RULES AND RADIOGRAPH UTILIZATION IN ANKLE INJURIES: A RETROSPECTIVE STUDY FROM A TERTIARY CARE EMERGENCY DEPARTMENT IN SOUTH INDIA

Background: Ankle injuries commonly undergo radiographic evaluation in the emergency department. The Ottawa AnkleRules (OAR) are validated clinical decision tools intended to guide imaging. This study assessed documented OAR use andits association with radiograph utilization. Materials and Methods: A hospital-based retrospective record review wasconducted in a tertiary care emergency department from 1 June 2020 to 1 June 2023. Patients aged >12 years with ankleinjuries were included. Demographic characteristics, documented or reconstructable OAR assessment, bony tenderness,weight-bearing ability, radiograph utilization, treatment, and disposition were analysed. Results: Eighty-one patients wereincluded; the mean age was 30.5 ± 12.9 years and 67.9% were female. OAR assessment was documented or reconstructablein 63 patients (77.8%). Radiographs were obtained in 77 patients (95.1%). Of those radiographed, 14 (18.2%) had fracturesand 63 (81.8%) had no fracture. Radiography was performed in 60/63 patients (95.2%) with recorded OAR assessment and17/18 (94.4%) without recorded assessment (p>0.05). Conclusion: Although OAR assessment was recorded in approximatelythree-quarters of patients, radiograph utilization remained high and was not lower when assessment was recorded. Prospective,standardized application of the complete rule is required to determine whether imaging can be safely reduced.