Sprained ankle

5% of all emergency-patients come to a clinic with an aching ankle, but only in 15% of all cases the ankle is really broken. To get the inflationary use of unnecessary radiographs under control, a special set of analysis-rules – the so called Ottawa Ankle Rules – were developed 1992 in Canada, which make the emergency-personal able, to definitely exclude a fraction of an ankle joint, without x-raying the foot. A group of scientists around Lucas Bachmann from the Horten-Centre for practice-oriented research in Zurich has analysed 32 studies to use the Ottawa-rules in detail (“British Medical Journal, vol. 326, p 417-419). As a result it was indicated that this kind to examine gave nearly 100% certainty whether ankles are broken or not and the use of x-rays can be diminished about 30 -40%. Even though many physicians appreciate this success, the Ottawa-rules are very rarely in practical operation. Obviously, many physicians need a maximum of security and so they use x-ray already in slightest doubt. This extreme need of security has to be taken into consideration, so the authors, if the Ottawa-rules should resort to a very effective cost-cutting measure.