Which ankle injury scoring system most accurately indicates the need for x-ray?
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The Ottawa Ankle Rules (OAR) are the most sensitive and, when negative, safely rule out a fracture. The OAR reduce the need for x-rays by 24% to 29%. The Utrecht rules are the most specific and, when positive, are the best for predicting the presence of a fracture. (SOR B, based on validating cohort and comparison studies.)
Evidence Based Practice 13(1): 05-06.