Applicability of Ottawa ankle rules in predicting the need for radiography in ankle and midfoot injuries in Rwanda

Objective: To assess the applicability of Ottawa Ankle Rules in predicting the need for the radiography in ankle and midfoot injuries in Rwanda.Design: This was a prospective multicenter cross-sectional study carried over a 6 month duration, from May 2018 to October 2018.Setting: University Teaching Hospital of Kigali (UTH-Kigali), Rwanda Military Hospital (RMH) and King Faisal Hospital, Kigali, Rwanda (KFH-K).Patients and methods: Adult patients presenting with acute ankle and midfoot injuries at the emergencies of three referral hospitals in Kigali. Patients were examined using OARs and underwent radiography to rule out the presence or absence of the fracture.Results: A total of 196 patients from three referral hospitals in Kigali were enrolled in the study. The sensitivity and specificity of the OARs were 97.9% and 35.8% respectively.Conclusion: In this study, Ottawa Ankle Rules have high sensitivity and low specificity; however, it showed high false positive values due to high sensitivity of the test. When properly applied, Ottawa Ankle Rules can decrease the number of unnecessary ankle or midfoot radiographs and limiting the waiting time in acute settings in Rwanda. Key words: Ottawa ankle rules, Radiography, Applicability, Validatio