Ankle Algorithm

An interactive decision flowchart for ankle and foot complaints. It applies the Ottawa Ankle Rule for inability to bear weight or malleolar and midfoot tenderness, the Bernese Ankle Rules using a 128 Hz tuning fork over the malleolus, subjective difficulty with plantarflexion of the great toe during push-off, and the paper grip test. It separates ankle or foot fracture, anterior ankle impingement, weakness of the hallux plantarflexors, functional hallux limitus, urgent referral, and specific pathology being unlikely.

Written for qualified clinicians. The tool supports clinical reasoning; it does not replace examination, imaging or diagnosis.