Are Ottawa knee rules useful in actual trauma care?
Acute knee injuries are a common presentation to the emergency department(ED). Ottawa knee rules (OKR) have shown to reduce the number of radiographs in these patients in North American studies and a fracture rate of 5% has been reported. Based on this, we tested the hypothesis that it was possible to decrease the number of x-ray films obtained after a knee trauma without delayed fracture diagnosis by means of the Ottawa knee rules in British set up. A total of 118 adult patients with acute Knee injuries were studied. A checklist in an easy-to-use format was produced to act as an aide-memoir and to encourage clinicians to apply the OKR in their decision making. Sixty patients were studied before introducing the check list stickers of OKR and fifty eight were studied after introducing the stickers. The OKR were found to have been obeyed in 24 (40%) of patients in the group which did not have stickers. In the group assessed without an OKR sticker, 28 (46.7%) of patients had knee radiography, compared with 29 (50%) of patients in the group who were assessed with an OKR sticker. There was no decrease in the number of x-rays after following the Ottawa Knee Rules (OKR).
-  S.E. Gwilym, N. Aslam, W.J. Ribbbans and V. Holloway: “The impact of implementing the Ottawa ankle rules on ankle radiography request in A & E”, Int. J. Clin. Pract., Vol. 57, (2003), pp. 625–627.
-  I.G. Steill, G.A. Wells, I. McDowell, G.H. Greenburg, R.D. Mcknight, A.A. Cwinn, J.V. Quinn and A. Yeats: “Use of radiography in acute knee injuries: need for clinical decision rules”, Acad. Emerg. Med., Vol. 2, (1995), pp. 966–973.
-  I.G. Stiell, G.H. Greenberg, G.A. Wells, R.D. Mcknight, A.A. Cwinn, T. Cacciotti, I. McDowell N.A. Smith: “Derivation of a decision rule for the use of radiography in acute knee injuries”, Ann. Emerg. Med., Vol. 26, (1995), pp. 405–413. http://dx.doi.org/10.1016/S0196-0644(95)70106-0[Crossref]
-  I.G. Stiell, G.H. Greenberg, G.A. Wells, I. McDowell, A.A. Cwinn, N.A. Smith, T.F. Cacciotti and M.L. Sivilotti: “Prospective validation of a decision rule for the use of radiography in acute knee injuries”, JAMA, Vol. 275, (1996), pp. 611–615. http://dx.doi.org/10.1001/jama.275.8.611[Crossref]
-  I.G. Stiell, G.A. Wells, R.H. Hoag, M.L. Sivilotti, T.F. Cacciotti, P.R. Verbeek, K.T. Greenway, I. McDowell, A.A. Cwinn, G.H. Greenberg, G. Nichol and J.A. Michael: “Implementation of the Ottawa knee rule for the use of radiography in acute knee injuries”, JAMA, Vol. 278, (1997), pp. 2075–2079. http://dx.doi.org/10.1001/jama.278.23.2075[Crossref]
-  G. Nichol, I.G. Stiell, G.A. Wells, L.S. Juergensen, A. Laupacis: “An economic analysis of Ottawa knee rule”, Ann. Emerg. Med., Vol. 34, (1999), pp. 438–447. http://dx.doi.org/10.1016/S0196-0644(99)80044-4[Crossref]
-  P.B. Richman, C.F. McCuskey, A. Nashed, S. Fuchs, R. Petrik, M. Imperato and X. Hollander: “Performance of two clinical decision rules for knee radiography”, J. Emerg. Med., Vol. 15, (1997), pp. 459–463. http://dx.doi.org/10.1016/S0736-4679(97)00073-5[Crossref]
-  D.C. Seaberg, D.M. Yealy, T. Lukens, T. Auble, S. Muthias: “Multicenter comparison of two clinical decision rules for the use of radiography in acute, high risk knee injuries”, Ann. Emerg. Med., Vol. 32, (1998), pp. 8–13. http://dx.doi.org/10.1016/S0196-0644(98)70092-7[Crossref]
-  S. Tigges, S. Pitts, S. Mukundan S Jr, Morrison D, Olson M, Shahriari A: “External validation of the Ottawa knee rules in ans urban trauma centre in United States”, Am. J. Roentgenol., Vol. 172, (1999), pp. 1069–1071.