4- sports injury

Question 1

Compartment syndrome

Answer 1

serious life- and limb-threatening complication of extremity trauma that occurs when rising pressure in a muscle compartment impairs perfusion to that same muscle compartment

Question 2

treatment for compartment syndrome

Answer 2

decompression via fasciotomy.

emergency!

Question 3

The 6 P’s (Signs of limb threatening Injury)

Answer 3

Pain
Pallor
Pulselessness
Paresthesia 
Perishing cold 
Paralysis

Question 4

what should you do before checking out injured led?

Answer 4

check out noninjured leg as baseline

Question 5

Lateral ankle sprains

Answer 5

present acutely (after trauma) with pain, warmth, and some swelling. Ankle sprains do not create a deformity.

Question 6

Peroneal tendon tear

Answer 6

due to an inversion injury and may occur in conjunction with a lateral ankle sprain. Patient may complain of persistent pain posterior to the lateral malleolus. Swelling may or may not be present

Question 7

Fibular fracture

Answer 7

due to a fall, an athletic injury, or a high velocity injury such as motor vehicle accident. Patient may have severe pain, swelling, inability to ambulate, and deformity

Question 8

Talar dome fracture

Answer 8

due to acute injury. Overall prognosis is related to potential for interruption of the blood supply. Talar dome fracture may occur in conjunction with an ankle sprain, and initial x-rays may miss a talar dome fracture. Repeat imaging may be required if symptoms persist to detect avascular necrosis after talar dome fracture.

Question 9

Subtalar dislocation

Answer 9

high-energy injury involving the talocalcaneal and talonavicular joints. Pain, swelling, and deformity are present.

Question 10

Medial ankle sprain

Answer 10

Somewhat rare and suggests that forced eversion has occurred. There is typically injury to the deltoid ligament.

Question 11

syndesmotic sprain

Answer 11

Generally involves the interosseus membrane and the anterior inferior tibiofibular ligament. Pain and disability are often out of proportion to the injury. One would expect a positive ankle squeeze test.

Question 12

Fracture of tibia

Answer 12

Often follows a high velocity trauma. Often the patient experiences severe pain and is unable to bear weight at all. There may be visible malformation of the extremity.

Question 13

which ligament in ankle is most easily injured

Answer 13

anterior talofibular ligament

Question 14

anterior drawer test can be used to assess the integrity of which ligament

Answer 14

anteriortalofibular ligament,

Question 15

inversion stress test can be used to assess the integrity of which ligament

Answer 15

calcaneofibular ligament.

Question 16

The most common mechanism of injury in ankle sprains is a combination of

Answer 16

plantar flexion and inversion.

Question 17

In medial ankle sprains, the mechanism of injury is excessive

Answer 17

eversion and dorsiflexion.

Question 18

Grade I sprain

Answer 18

stretching and/or a small tear of a ligament.

mild tenderness and swelling, slight to no functional loss, and no mechanical instability.

No excessive stretching or opening of the joint with stress.

Question 19

Grade II sprain

Answer 19

incomplete tear and moderate functional impairment.

tenderness over the involved structures, with mild to moderate pain, swelling, and ecchymosis.

some loss of motor function and mild to moderate instability. Stretching of the joint with stress, but with a definite stopping point.

Question 20

Grade III sprain

Answer 20

complete tear and loss of integrity of the ligament.

Severe swelling (greater than 4 cm about the fibula) and ecchymosis may be present, along with inability to bear weight and mechanical instability.

Significant stretching of the joint with stress, without a definite stopping endpoint.

Question 21

ottowa ankle rules

Answer 21

clinical decision tool designed to help in evaluation of adults (age 18 and up) with acute ankle and midfoot injuries to see if they need imaging

Question 22

The rules suggest that radiographs of the ankle are needed if:

Answer 22

There is pain in the malleolar zone
AND
either bony tenderness along the distal 6 cm of the posterior edge of either malleolus
OR
inability to bear weight 4 steps both immediately after the injury and in the emergency department.

Question 23

Radiographs of the foot are needed if:

Answer 23

There is pain in the midfoot region
AND one of the following:

(a) bony tenderness at either the navicular bone or base of the fifth metatarsal
(b) inability to bear weight four steps immediately after the injury and in the emergency department.

Question 24

Negative inversion test:

Answer 24

Invert the patient’s ankle. Laxity indicates injury of the calcaneofibular ligament.

Question 25

Crossed-leg test:

Answer 25

Have the patient cross their legs with the injured leg resting at midcalf on the knee to detect high ankle sprains (syndesmotic injury between the tibia and fibula).

Question 26

RICE

Answer 26

Rest- 72 hrs
Ice
Compression
Elevation

Question 27

Most Effective Compression For Ankle Injury

Answer 27

semi-rigid ankle support

Question 28

what is this? hearing a popping sound followed by immediate pain in the posterior right ankle. On physical exam, the posterior right ankle is edematous and palpation is tender. He is unable to plantarflex his right foot.

Answer 28

achilles tendon rupture

Question 29

do you give antibiotics to patient with UTI symptoms (dysura, frequency) but a normal UA?

Answer 29

yes