4- sports injury Flashcards
Compartment syndrome
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
treatment for compartment syndrome
decompression via fasciotomy.
emergency!
The 6 P’s (Signs of limb threatening Injury)
Pain Pallor Pulselessness Paresthesia Perishing cold Paralysis
what should you do before checking out injured led?
check out noninjured leg as baseline
Lateral ankle sprains
present acutely (after trauma) with pain, warmth, and some swelling. Ankle sprains do not create a deformity.
Peroneal tendon tear
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
Fibular fracture
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
Talar dome fracture
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.
Subtalar dislocation
high-energy injury involving the talocalcaneal and talonavicular joints. Pain, swelling, and deformity are present.
Medial ankle sprain
Somewhat rare and suggests that forced eversion has occurred. There is typically injury to the deltoid ligament.
syndesmotic sprain
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.
Fracture of tibia
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.
which ligament in ankle is most easily injured
anterior talofibular ligament
anterior drawer test can be used to assess the integrity of which ligament
anteriortalofibular ligament,
inversion stress test can be used to assess the integrity of which ligament
calcaneofibular ligament.
The most common mechanism of injury in ankle sprains is a combination of
plantar flexion and inversion.
In medial ankle sprains, the mechanism of injury is excessive
eversion and dorsiflexion.
Grade I sprain
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.
Grade II sprain
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.
Grade III sprain
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.
ottowa ankle rules
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
The rules suggest that radiographs of the ankle are needed if:
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.
Radiographs of the foot are needed if:
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.
Negative inversion test:
Invert the patient’s ankle. Laxity indicates injury of the calcaneofibular ligament.
Crossed-leg test:
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).
RICE
Rest- 72 hrs
Ice
Compression
Elevation
Most Effective Compression For Ankle Injury
semi-rigid ankle support
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.
achilles tendon rupture
do you give antibiotics to patient with UTI symptoms (dysura, frequency) but a normal UA?
yes
