Stirrup brace for small avulsion type injuries below the joint line Short leg cast - after initial swelling subsides Posterior splint with or without U-splint for initial visit, if referring or using a cast for definitive management Indicated for non to minimally displaced stable injuries (NO MORTISE WIDENING) X-Ray - AP, lateral, mortise, weight bearing views +/- stress view Įvaluate for fracture, displacement, and mortise widening May or may not be able to weight bear, depending on severity and individual pain tolerance Usually an excessive inversion or rotational mechanism to the point of bone failure Total ankle replacement is becoming more common X-Ray (AP, Lateral, Mortise weight-bearing views) Usually gradual progressively worsening ankle pain Primary repair may be best choice for younger and active populationĬhronic or post-traumatic articular cartilage degeneration of the talocrural joint IF diagnosis suspected, but not confirmed with exam MRI or US indicatedīoot with serial wedges has recently shown to be effective Tendon defect palpable and usually visibleĮvaluate for bony avulsion if defect is close to insertion May/may not be able to ambulate, but limited push-off if able t Mechanism frequently involves trying to control a decent (coming down from a jump or stairs) or sudden forceful contraction (pushing off to sprint or jump)įrequently described as "it felt like something hit the back of my leg" Usually an eccentric load that supersedes tendon strength, causing failure Lateral may show posterior calcaneal enthesopathyīoot or cast for up to 6 weeks, if refractory to other conservative treatment Increased pain with push-off or stretch (stairs is a common complaint) Surgical referral if conservative options fail TTP over tendon proximal and posterior to medial malleolusĪppropriate if conservative treatment fails, to evaluate for tearing Severe injuries with mortise widening on X-RayĪcute inflammation of the posterior tibial tendonĬhronic failure of the posterior tibial tendon to maintain normal function Short period of immobilization, NWB with crutches if unable to WB Usually negative, but may see mortise widening or talar lateralization if significant syndesmotic and deltoid ligament injury Pain and/or instability with, drawer tests, talar tilt test, Kleiger test Syndesmosis involvement = "high ankle sprain" and can take longer to resolve Inversion - ATF, CF, PTF possible syndesmosis Stretch injury to any of the ankle ligaments (ATF, PTF, CF, Deltoid, A&P Tib/fib, syndesmosis), which can cause ligament failure
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |