Foot & Ankle Fractures

Question 1

What are the Ottawa rules of the ankle & foot (Malleolar zone)?

Answer 1

X-ray is only required when:
- Bony tenderness at the posterior edge or tip of lateral malleolus
- Inability to bear weight both immediately and in A&E

Question 2

What are the Ottawa rules of the ankle & foot (Mid-foot zone)?

Answer 2

X-ray is only required when:
- Bony tenderness at the base of 5th metatarsal
- Bony tenderness at Navicular
- Inability to bear weight both immediately and in A&E

Question 3

What are the bony landmarks of the ankle & foot?

Answer 3

• Medial Malleolus
• Lateral Malleolus
• Talocrural joint line
• Head & neck of talus
• Sustentaculum tali of the calcaneus
• Navicular
• Medial cuneiform
• Base of 1st metatarsal
• Head of 1st metatarsal
• Peroneal tubercle
• Cuboid
• Base of 5th metatarsal
• Mid-tarsal (transverse tarsal) joint
• Metatarsals