10.6 Mechanical Injury Flashcards
Sprain vs strain
Sprain: stretch or tear in a ligament
STrain: stretch or tear in muscle/Tendon
P = Pair = 2 Bones = Ligament
Describe treatment of strains
- RICE
- Plus or minus NSAIDs
- Gentle ROM and stretching early
- Once pain is resolved, progress to strengthening
Recall the grades of sprain
Grade I: overstretching; no tearing (2-4 weeks recovery)
Grade II: Partial tear of ligament(s) (4-8 weeks recovery)
Grade III: Complete ligament(s) tear. ~12 weeks recovery.
What exam findings might indicate ankle sprain?
Look: swelling, bruising
Feel: tenderness, warmth
Move: anterior drawer
Outline common management of strains (high grade vs low grade)
Low grade:
RICE (with early return to motion; remember Courtney Conley)
High grade:
Surgical repair or prolonged casting
What are indications for surgery during foot/ankle trauma?
- Syndesmosis injury
- Recurrent strains/sprains, causing chronic instability
What are the consequences of not urgently reducing an ankle dislocation
- Neurovascular compromise
- Skin breakdown
- Compartment syndrome (pressure buildup)
What is the most common mechanism of ankle sprain? (Hint: soccer player) What ligaments would this damage?
- Inversion-type roll on a plantar-flexed foot.
- Stretches lateral foot; therefore, most commonly damages fibular ligaments (a/p talofib/calcaneofib)
What are common mechanisms of acute vs chronic strains?
Acute: poor mechanics in a single lift
Chronic: overuse/repetitive strain
Describe the utility of x ray for ankle/foot injuries
- Useful for bony structures
- Not useful for soft-tissue structures
- Can show diastasis (separation of structures that are normally together)
(Cheap, fast, easy)
Describe the utility of ultrasound for foot/ankle injuries
- Useful for diagnosing Achilles tendon ruptures
- Requires skilled sonographer
- Relatively cheap
Describe the utility of MRI in foot/ankle injuries
- Gold standard for ligament/tendon injuries
- Often not required; clinical diagnosis
- Expensive, scarce, time-hungry
