Execution:
- Palpate for tenderness on the posterior edge of the medial and lateral malleoli from the distal tip up 6cm
- Palpate for tenderness or pain at the navicular bone and 5th metatarsal
- Ask the patient to walk 4 consecutive steps (limping is permitted)
Positive Outcome: Tenderness on the any of the first two steps or the patient is unable to walk four consecutive steps
| Study | Reliability | Sn | Sp | LR+ | LR- |
| Bachmann et al. (2003) | NA | 97.6 | 31.5 | 1.42 | 0.08 |
| Dowling et al. (2011) | NA | 98.5 | 7.9-50 | NA | 0.11 |
| Gomes et al. (2022) | NA | 91 (89-92) | 25 (24-26) | 1.47 (1.11-1.93) | 0.15 (0.72-0.29) |
| Comment: The OAR are one of the best researched screening tools. However, in the US this screening tool is usually not used due to insurance policies which make x-rays obligatory. The OAR are more sensitive within the first 48h after the trauma. | |||||
