Ankle sprains March 2018 | by EMauthor •Very common problem •Most common is lateral ligament sprain from inversion injury •The patient presents with swelling and tenderness in front and below lateral malleolus •Examination, palpate oLateral and medial malleoli oBase of 5th metatarsal, oOs calcis and navicular bone oAssess the integrity of Achilles tendon oAssess weight bearing •X-ray is indicated if oThe patient can not weight bear oBony tenderness over posterior edge of tibia or fibula •Treatment oMost patients are able to walk. Treat with analgesia, rest and elevation with an ankle injury advice sheet. Tubigrip is probably unnecessary oFor more severe injuries where the patient can not weight bear, treat as above with crutches. The patient should be advised to start weight bearing as soon as possible oEarly physiotherapy can benefit patients with severe sprain •Small avulsion fractures seen on x-ray can be treated on same lines. However if the patient can not weight bear and present with severe symptoms, they can benefit from a short period of plaster immobilisation (below knee POP slab) for 7-10 days. They should be brought back to the review clinic after this time for re-assessment. |
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