Tormey P, et al. - Researchers sought to introduce the Low Risk Ankle Rule (LRAR) into their department and to determine how it impacts the radiography rate and length of stay (LOS). The baseline rate of radiography and LOS in the department were determined via performing an audit of x-ray rates in ankle injuries in 2016. Education sessions were then conducted and x-ray ordering prompts were created to encourage clinicians to use the LRAR. In 2016, there were 969 patients who presented in with an ankle injury; of these, 90.7% had an x-ray. The median LOS of 109 min was observed. During the LRAR implementation period, 92 patients presented with an ankle injury; of these, following the implementation of exclusion criteria, they assessed 79 patients. Of these 79 patients, 49 had a LRAR positive exam. During the study period, the overall x-ray rate was 40/92 (43.4%), a reduction of 47.3% with no clinically significant missed fractures. The average LOS was 101 min during the study. These findings support the safety and effectiveness of the LRAR in reducing the rate of radiography in ankle injuries, without missing any clinically significant fractures.