快速诊断规则用于鉴别足踝扭伤有无骨折的临床分析

目的探讨应用快速诊断规则（OAR）鉴别足踝扭伤伴骨折的漏诊原因，指导OAR的合理应用。方法选择2005年3月至2010年3月在泸州医学院外科门诊就诊的足踝扭伤患者，应用OAR进行临床检查并做出有无骨折的判断，于受伤后24h内和第15天进行足踝x线摄片，验证OAR诊断结果的准确性。结果根据OAR原则，踝关节扭伤105例中初步诊断16例合并骨折，经x线检查合并骨折17例，漏诊1例（6．2％）；足扭伤50例患者中21例合并骨折，OAR原则与x线摄片诊断结果一致。结论OAR对足踝扭伤并骨折的判断准确率高，但也有漏诊的可能，临床要警惕。

Accuracy of ottawa ankle rules to exclude fractures of the ankle and mid-foot

Objective To identify the reasons of missed diagnosis with ankle sprains by analyzing OAR in order to guide the rational use of OAR. Methods Outpatient with sprained ankles were recruited from the surgical clinic in Sichuan Luzhou Medical College from Mar. 2005 to Mar. 2010. OAR was used for clinical diagnosis of ankle sprains. The accuracy of OAR diagnosis was examined within 24 h and at 15 d by X- ray. Results In the 105 cases of ankle sprain, 16 cases was diagnosed of fractures by OAR. X-ray results showed 1 case of missed diagnosis, with the rate of missed diagnosis of 6. 2%. While both OAR and X-ray diagnosed 21 cases in 50 patients with sprained foot fractures,with a rate of missed diagnosis of 0. Conclusion OAR diagnosis for ankle sprains and fractures has high success rate although with the possibility of missed diagnosis which needs attention clinically.