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Ottawa Ayak Bileği ve Ayak Kuralları (Ottawa Ankle and Foot Rules)

Ottawa Ayak Bileği ve Ayak Kuralları (Ottawa Ankle and Foot Rules). Doç. Dr. Zekeriya Aktürk TÜTF Aile Hekimliği AD http://aile.trakya.edu.tr 20 Aralık 2004. Ebell MH. Evaluating the Patient with an Ankle or Foot Injury. Am Fam Phys 2004;70(8):1535-1536). Fibula Tibia Bilek eklemi

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Ottawa Ayak Bileği ve Ayak Kuralları (Ottawa Ankle and Foot Rules)

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  1. Ottawa Ayak Bileği ve Ayak Kuralları(Ottawa Ankle and Foot Rules) Doç. Dr. Zekeriya Aktürk TÜTF Aile Hekimliği AD http://aile.trakya.edu.tr 20 Aralık 2004 Ebell MH. Evaluating the Patient with an Ankle or Foot Injury. Am Fam Phys 2004;70(8):1535-1536) / 9

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  4. Fibula • Tibia • Bilek eklemi • Tibia çıkıntısı (Promontorium) • Talusun troklear yüzeyi • Talus • Talusun arka tuberkülü • Kalkaneus • Sustentaculum tali • Tarsal tünel • Naviküler kemik • Kuneiform kemik • Küboid kemik / 9

  5. Problem • Ayak ve ayak bileği travmalarında %83 grafi istenmektedir. • Travmaların %10’unda kırık vardır. National Guideline Clearinghouse, www.guideline.gov / 9

  6. Ottawa Kuralları • 1992’de Stiel ve ark. tarafından geliştirildi (Ottawa, Ontario, Kanada) • 18 yaşın üzerindeki bireylerde ayak bileği ve ayak travmalarında grafi için karar desteği sağlar. Stiell IG, Greenberg GH, McNight RD, Nair RC, McDowell I, Reardon M ve ark. Decision rules for the use of radiography in acute ankle injuries. Refinement and prospective validation. JAMA 1993;269:1127-1132. Stiell IG, McKnight RD, Greenberg GH, McDowell I, Nair RC, Wells GA, Johns C, Worthington JR. Implementation of the Ottawa ankle rules. JAMA 1994 Mar 16;271(11):827-32 / 9

  7. Ebell MH. Evaluating the Patient with an Ankle or Foot Injury. Am Fam Phys 2004;70(8):1535-1536) / 9

  8. Ottawa Ayak Kuralı Ottawa Ayak Bileği Kuralı / 9

  9. Ottawa Kuralları • Duyarlılığı %100, Özgüllüğü %30-40. • Duyarlılığı %100, Özgüllüğü %30-40. • Ayak bileği filmlerinin istenmesini %28, ayak filmlerinin istenmesini %14 azaltır. (Ortalama %83’ten %61’e). • Odds oranı 2.9, NNT: 4.6 • Hastanede geçirilen zamanı azaltır (116 dakikadan 80 dakikaya) • Masrafları azaltır (173 $’dan 62 $’a) Bondolier. Ottawa ankle rules revisited, http://www.jr2.ox.ac.uk/bandolier/band21/b21-5.html National Guideline Clearinghouse, www.guideline.gov / 9

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