Sprains

Question 1

What are sprains

Answer 1

A stretch or tear of a ligament

Typically affects the ankles, knees, wrist and thumb,

Question 2

What are the symptoms of a sprain?

Answer 2

Pain/tenderness
Swelling
Bruising
Decreased functioning
Joint instability

Question 3

What is a strain?

Answer 3

Stretch or tear of muscle fibres and/or tendon.
Typically affects the foot, hamstring and back.

Question 4

What are the symptoms of a strain?

Answer 4

Muscle pain
Cramping or spasming
Muscle weakness
Inflammation
Bruising

Question 5

What are the risk factors of a strain/sprain?

Answer 5

Sports
Increased age
Falls
Previous injury
Chronic instability/hypermobility
Reduced balance
Neuropathy
Excessive alcohol/drugs
High/low BMI

Question 6

What are the common sprains?

Answer 6

Ankle - Anterio talofibular liagmant (ATFL) / Posterior talofibular ligament (PTFL)

Knee - Anterior cruciate ligament (ACL) / Medial / Lateral collateral ligament (MCL/LCL)

Wrist - Scapholunate ligament

Thumb - Ulnar collateral ligament (UCL) where thumb meets palm

Question 7

What is the most common sprain?

Answer 7

Lateral ankle sprain.

Question 8

How many people in 10 years (2012-2022) were registered with an ACL injury?

Answer 8

18,668 people

Question 9

What are some common strains?

Answer 9

Hamstring - 10% of all field based sports.

Achilles tendon injury - approx 4500 people in the UK have tendon rupture.

Question 10

What is the pre hospital management of a sprain/strain?

Answer 10

Full examination
Full MSK and obs
Analgesia
Referral option - GP

Question 11

What are some red flags for conveyance to hospital with someone that has a suspected strain/sprain?

Answer 11

Fracture
Underlying pathophysiology
Disability indicative of ligament rupture
Acute inflammation or infection (eg septic arthritis)

Question 12

What does PRICE mean regarding sprain/strain management if pt discharge?

Answer 12

P-rotection from further injury (remove hazards)
R-est, avoid activity for first 48-72hrs
I-ce 15-20mins indirect contact ever 2-3 hours for first 2/3 days.
C-ompression - simple elastic bandage, remove before sleep.
E-levate keep elevated until swelling is controlled.

Question 13

What are the red flags of a strain/sprain?

Answer 13

-Fracture/dislocation
-Damage to nerves/cirulation
-Clotting disorder
-Penetrating joint wound
-Serious complication such as septic arthritis.
-Tendon rupture
-Complete tear or more than half tear
-Large intramuscular haematoma.

Question 14

What sprains/strains will most likely require surgery?

Answer 14

-Achilles tendon rupture
-ACL/PCL rupture
-Complete hamstring/glute tear
-Tendon rupture in hands/fingers
-Penetrating trauma casing damage to underlying muscle /ligament or tendon structures.