The Ottawa ankle rules (OAR) are a set of guidelines to help the physician as to decision making regarding need for x ray examination after ankle and mid-foot injury. A previous best evidence topic report examined whether these rules could be applied to children.¹ At that time there was insufficient evidence to make a determination. This appraisal updates that topic.

Structured clinical question

In a child with history of ankle injury [patient] are the Ottawa ankle rules [test] reliable in eliminating the need for x ray examination in some patients without the risk of missing fractures [outcome]?

Search strategy and outcome

Secondary sources

Cochrane—two trials that involved children were found in Central.

Primary sources

PubMed—(Clinical Queries) Ottawa ankle rules AND child.

One systematic review was found that included 27 studies, six of which were pertaining to children, two of which were the trials found in Central. Eight total prospective studies were found; six were …