title: Ottawa versus Bernese: which is better?
abstract: OBJECTIVE
  Trauma of the foot and ankle is commonly seen in the emergency service. For most patients, fractures cannot be ruled out without radiography. The aim of this study is to consider these injured patients in the light of the Ottawa ankle rules and the Bernese ankle rules.
  
  
  METHODS
  Our study is a randomized, prospective clinical study. This study was performed during a 24-month period in the Süleyman Demirel University Emergency Medicine Service. A total of 962 adult patients with foot and ankle pain or tenderness following trauma incurring within the previous 10 days were included in the study. Patients were examined only by physicians who had been trained in the correct application of the Ottawa ankle rules and the Bernese ankle rules. All patients were X-rayed with standardized anterior-posterior and lateral radiographs of the ankle and foot, regardless of whether the Ottawa ankle rules and the Bernese ankle rules were positive or negative. The sensitivity and specificity of the Ottawa and Bernese ankle rules according to the study results regarding the correlation between physical examination and radiography were calculated.
  
  
  RESULTS
  For the Ottawa ankle rules, the sensitivity was 74.8 %, specificity was 68.6 %, false-negative ratio was 15.1 %, and the false-positive ratio was 46.3 %. For the Bernese ankle rules, the sensitivity was 55.7 %, specificity was 79 %, false-negative was ratio 21.4 %, and the false-positive ratio was 43.7 %.
  
  
  CONCLUSIONS
  These data suggest that the Ottawa ankle rules are more sensitive than the Bernese ankle rules to accurately identify the fracture, but they are still not 100 % reliable.
authors.affiliation: Department of Emergency Medicine, Süleyman Demirel University Medical School, Isparta, Turkey. gokbencetin@hotmail.com.
authors.forename: G N
authors.initials: GN
authors.lastname: Beceren
authors.affiliation: Department of Emergency Medicine, Bozok University Medical School, Yozgat, Turkey. sadiyeyolcu@yahoo.com.
authors.forename: S
authors.initials: S
authors.lastname: Yolcu
authors.affiliation: Department of Emergency Medicine, Süleyman Demirel University Medical School, Isparta, Turkey. ondertomruk@hotmail.com.
authors.forename: O
authors.initials: O
authors.lastname: Tomruk
authors.affiliation: Department of Orthopedics and Traumatology, Süleyman Demirel University Medical School, Isparta, Turkey. ataytolga@gmail.com.
authors.forename: T
authors.initials: T
authors.lastname: Atay
authors.affiliation: Department of Orthopedics and Traumatology, Süleyman Demirel University Medical School, Isparta, Turkey. barbarosbaykal@gmail.com.
authors.forename: Y B
authors.initials: YB
authors.lastname: Baykal
keywords: Bernese ankle rules; Ottawa ankle rules; Trauma of ankle; X-ray
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