{"id":11496,"date":"2022-08-18T15:23:39","date_gmt":"2022-08-18T13:23:39","guid":{"rendered":"https:\/\/www.physiotutors.com\/?post_type=wiki&amp;p=11496"},"modified":"2022-08-18T15:23:39","modified_gmt":"2022-08-18T13:23:39","slug":"low-risk-ankle-rule","status":"publish","type":"wiki","link":"https:\/\/www.physiotutors.com\/wiki\/low-risk-ankle-rule\/","title":{"rendered":"Low Risk Ankle Rule"},"featured_media":11497,"template":"","class_list":["post-11496","wiki","type-wiki","status-publish","has-post-thumbnail","hentry"],"acf":{"sections":[{"acf_fc_layout":"page-header-detail-page","background":{"background_image":11497,"background_image_alt_text":"Low Risk Ankle Rule"},"heading":"Low Risk Ankle Rule | Ankle Fracture in Children","subheading":"Screening","content_editor":"","button_type":"internal_link","button_label":"Check our shop","button_style":"button-five","button_internal_link":"","button_anchor":"","button_url":"","button_file":"","label":""},{"acf_fc_layout":"submenu","links":[{"button_type":"anchor","button_label":"Learn","button_internal_link":null,"button_anchor":"section-number-3","button_url":"","button_file":null},{"button_type":"anchor","button_label":"Assessment E-Book","button_internal_link":null,"button_anchor":"section-number-4","button_url":"","button_file":null},{"button_type":"anchor","button_label":"Reviews","button_internal_link":null,"button_anchor":"section-number-5","button_url":"","button_file":null}],"dropdown_label":"Go to","button_right":{"button_type":"internal_link","button_label":"Become a member","button_style":"button-three","button_internal_link":16662,"button_anchor":"","button_url":"","button_file":""},"button_description":"Find this wiki on the Physiotutors platform"},{"acf_fc_layout":"content-content","section_options":{"vertical_alignment":"top","column_right_box":false,"column_left_width":"col-12 col-lg-4 offset"},"column_left":{"content_editor":"<h4>Learn<\/h4>"},"column_right":{"content_editor":"<h6>Low Risk Ankle Rule | Ankle Fracture Assessment in Children under 16<\/h2>\n<span style=\"font-weight: 400;\">The Low Risk Ankle Rules is an ankle decision rule that is developed specifically for ankle injuries in children below the age of 16 as a screening tool for high-risk fractures that would warrant radiographic exploration versus low-risk injuries that don\u2019t. The definition of low-risk injuries includes lateral ankle sprains, nondisplaced Salter-Harris type I and II fractures, and avulsion fractures, which can all be managed functionally by supportive splinting and return to activities as tolerated by the patient.<\/span>\n\n<span style=\"font-weight: 400;\"><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3796622\/\" target=\"_blank\" rel=\"noopener\">Boutis et al. (2013)<\/a> report a sensitivity of 98% and specificity of 54% with the sensitivity being consistent with previous validation studies, which gives it a strong clinical value in excluding a fracture.<\/span>\n<div class=\"embed-container\">\n\n[embed]https:\/\/www.youtube.com\/watch?v=TWfyQTvmRys[\/embed]\n\n<\/div>\n<span style=\"font-weight: 400;\">The rule states that if a child presents with a low-risk injury on examination, which refers to tenderness and swelling that is isolated to the distal fibula and\/or adjacent lateral ligaments distal to the tibial anterior joint line, taking an additional x-ray may not be necessary to exclude a clinically important ankle injury.<\/span>\n\n&nbsp;\n\n[cta]\n\n&nbsp;\n\nOther common tests to screen for ankle fractures are:\n\n<a href=\"https:\/\/www.physiotutors.com\/wiki\/bernese-ankle-rules\/\">Bernese Ankle Rules<\/a>\n\n<a href=\"https:\/\/www.physiotutors.com\/wiki\/midfoot-zone-algorithm\/\">Midfoot Zone Algorithm<\/a>\n\n<a href=\"https:\/\/www.physiotutors.com\/wiki\/malleolar-zone-algorithm\/\">Malleolar Zone Algorithm for Fractures in Children<\/a>\n\n<a href=\"https:\/\/www.physiotutors.com\/wiki\/ottawa-ankle-rules\/\">Ottawa Ankle Rules<\/a>\n\n&nbsp;\n"}},{"acf_fc_layout":"content-content","section_options":{"vertical_alignment":"top","column_right_box":false,"column_left_width":"col-12 col-lg-4 offset"},"column_left":{"content_editor":"<h4>References<\/h4>"},"column_right":{"content_editor":"<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/15231460\/\" target=\"_blank\" rel=\"noopener\">Dayan, P. S., Vitale, M., Langsam, D. J., Ruzal\u2010Shapiro, C., Novick, M. K., Kuppermann, N., &amp; Miller, S. Z. (2004). Derivation of clinical prediction rules to identify children with fractures after twisting injuries of the ankle.\u00a0<i>Academic emergency medicine<\/i>,\u00a0<i>11<\/i>(7), 736-743.<\/a>\n\n<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3796622\/\" target=\"_blank\" rel=\"noopener\">Boutis, K., Grootendorst, P., Willan, A., Plint, A. C., Babyn, P., Brison, R. J., ... &amp; Narayanan, U. (2013). Effect of the Low Risk Ankle Rule on the frequency of radiography in children with ankle injuries.\u00a0<i>Cmaj<\/i>,\u00a0<i>185<\/i>(15), E731-E738.<\/a>"}},{"acf_fc_layout":"cta-image-v2","layout":"","background":"transparent","heading":"","content_editor":"<p class=\"subheading\">Like what you\u2019re learning?<\/p>\n<p class=\"heading-two\">BUY THE FULL PHYSIOTUTORS <strong>ASSESSMENT BOOK<\/strong><\/p>\n\n<ul>\n \t<li>600+ Pages e-Book<\/li>\n \t<li>Interactive Content (Direct Video Demonstration, PubMed articles)<\/li>\n \t<li>Statistical Values for all Special Tests from the latest research<\/li>\n \t<li>Available in \ud83c\uddec\ud83c\udde7 \ud83c\udde9\ud83c\uddea \ud83c\uddeb\ud83c\uddf7 \ud83c\uddea\ud83c\uddf8 \ud83c\uddee\ud83c\uddf9 \ud83c\uddf5\ud83c\uddf9 \ud83c\uddf9\ud83c\uddf7<\/li>\n \t<li>And much more!<\/li>\n<\/ul>","button_type":"internal_link","button_label":"Check out our 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