Ankle Injury : Sprain
This represents one of the most common orthopaedic injuries. A sprain refers to an injury to the ligaments. Ligaments are composed of a fibrous connective tissue that serve to stabilize a joint.
The ankle is often sprained when it is "folded" over on itself. This may happen when one walks on an uneven surface, down a hill, or steps into a hole.
Common symptoms include pain and difficulty with ankle motion that usually increases in severity after several hours. Patients with ankle sprains often attempt to walk on the injured ankle until the pain (and swelling) becomes too severe. Typically there is tenderness and swelling to the outer (lateral) aspect of the ankle joint.
Evaluation will include bone x-rays to rule out the presence of a fracture. A complete examination for nerve and blood vessel integrity will also be performed. More serious ankle sprains can result in complete separation of supporting ligaments and this usually becomes evident on physical examination.
Treatment includes ice packs and elevation of the ankle for 24 to 48 hours. Crutches are useful in all cases to avoid weight bearing on the injury. More serious sprains will be benefited by splinting (half cast), but most minor sprains can be effectively managed with a (Ace) bandage wrap. Acetaminophen, aspirin or anti-inflammatories (ibuprofen) are useful for pain control.
Orthopaedic consultation should be part of the follow-up. Ankle sprains can take up to 4-6 weeks to heal. Those who return to work after several weeks will often require additional ankle support (Aircast). Reinjury is common if adequate time is not allowed for recovery.
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