Um den inflationären Gebrauch von unnötigen Röntgenbildern einzudämmen, ist 1992 in Kanada ein spezielles Set von Untersuchungsregeln entwickelt worden - die so genannten Ottawa Ankle Rules – das es dem Notfallpersonal ermöglichen soll, eine Fraktur des Sprunggelenkes mit großer Sicherheit auszuschließen, ohne den Fuß zu röntgen. The Ottawa Ankle Rules determine the need for radiographs in acute ankle injuries. Clinical decision guidelines such as these not only avoid unnecessary health care and its costs but also help minimize exposure to ionizing radiation. Ottawa Ankle Rules Nach akuten Sprunggelenks- und Mittelfußdistorsionen wird bei sehr vielen Patienten eine Röntgenaufnahme gemacht, obwohl weniger als 15% eine Fraktur zeigen. Determine if the patient is able to flex his/her knee to 90° - this will be measured with a goniometer as follows:a. the axis of the goniometer is placed on the lateral epicondyle of the femurb. In dieser Meta-Analyse wurden die Testcharakteristika der «Ottawa Knee Rules» untersucht. Data sources: Electronic databases, reference lists of included studies, and experts. Studies show that they are highly sensitive at identifying patients with fractures of the knee and have a high degree of interobserver agreement and reproducible results. Isolated tenderness of the patella (no other bony tenderness), Unable to bear weight both immediately and in ED (4 steps, limping is okay). X-rays are indicated when: 1) ≥ 55 years old. Sie dienen mit einer nahezu … The Ottawa knee rules (OKRs) were first derived and validated in Ottawa, Canada, with the aim of reducing the number of unnecessary radiographs ordered after knee trauma without compromising patient care. Ottawa Knee Rules. When used appropriately, the amount of knee x-rays obtained can be reduced by around 20-30%. Stage of CPR Development: Validated. 4) unable to flex knee to 90° 5) unable to weight-bear and walk 4 steps in the ED (limping counts!) Stiell IG, et al. Rules have been prospectively validated on multiple occasions in different populations and in both children and adults. Rule: 1. Für alle Bedeutungen von OKR klicken Sie bitte auf "Mehr". No bone tenderness of knee other than patella. One study did find a sensitivity of just 86%. The Ottawa knee rules were 97 percent sensitive and 27 percent specific for knee fractures, with three fractures missed. Holroyd BR, Wilson D, Rowe BH, Mayes DC, Noseworthy T. Uptake of validated clinical practice guidelines: experience with implementing the Ottawa Ankle Rules. Check for sensitivity of the proximal fibula 2. Review methods: Data were extracted on the study population, the type of Ottawa ankle rules used, and methods. Specificities for the Ottawa Knee Rules typically range from 19%-50%, though the rule is not designed/intended for specific diagnosis. It is estimated that approximately 25,000 ankle sprains occur per day in the USA which equates to 1 sprain per 10,000 daily. When the Ottawa Knee Rules are executed, the following assessments will be performed: 1. Ann Emerg Med. The Ottawa knee rules are a set of rules used to help physicians determine whether an x-ray of the knee is needed. 2003; 42(1):48-55. For Knee Injury Radiography. Anterior cruciate ligament reconstruction, https://en.wikipedia.org/w/index.php?title=Ottawa_knee_rules&oldid=964500823, Creative Commons Attribution-ShareAlike License, Inability to flex the knee greater than 90°, Inability to bear weight both immediately and in the emergency department (4 steps), This page was last edited on 25 June 2020, at 21:30. 3) bony tenderness of fibula head. The Ottawa Knee Rules were developed in an effort to be able to minimize the number of radiographs needed for traumatic knee injuries. The Ottawa Knee Rules were derived to aid in the efficient use of radiography in acute knee injuries. However, specificity for the Ottawa knee rules is typically poor, meaning that a significant proportion of those who meet Ottawa knee criteria will have no knee fracture on X-ray. Investigator: Ian Stiell Summary: The Ottawa Knee Rule is a simple guideline developed to aid emergency physicians in deciding when to use radiography for patients with injuries to the knee. The Pittsburgh knee rules have been found to be more specific in diagnosis.[3]. (. Sensitivity: 98-100%. Ann Emerg Med. Isolated tenderness of … Tenderness of the head of the fibula.

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