The Ankle Part 2: Exam 3 Flashcards
(62 cards)
1
Q
MOI lateral ankle sprain
A
Inversion and plantar flexion
2
Q
Lateral ankle sprain ligaments
A
- ATFL
- CFL
3
Q
How ATFL is injured
A
Plantar flexion and inversion
4
Q
How CFL is injured
A
Inversion
5
Q
Etiology of grade one ligament sprain
A
- inversion and plantar flexion
- causes stretching of ATFL
6
Q
Symptoms of grade 1 ligament sprain
A
- mild pain and disability
- minimally impaired weight bearing
- point tenderness over ligament and no laxity
7
Q
Management of grade 1 sprain
A
- RICE 1-2 days
- limited weight bearing initially and then agressive strengthening rehab
- tape can provide additional support
- return to activity in 7-10 days
8
Q
Etiology of grade 2 sprain
A
-moderate inversion force causing great deal of disability with many days of lost time
9
Q
Symptoms of grade 2 sprain
A
- feel/ hear a pop or snap
- moderate pain with difficulty bearing weight
- tenderness and edema
- special tests will be positive for laxity
10
Q
Management of grade 2 sprain
A
- RICE for 72 hours
- x-ray to rule out fracture
- crutches for 5-10 days
- progress to weight bearing
11
Q
Etiology of grade 3 sprain
A
- relativity uncommon but extremely disabling
- caused by significant force resulting in spontaneous subluxation and reduction
- damages the anterior/ posterior talofibular and calcaneofibular ligaments as well as the capsule
12
Q
Symptoms of grade 3 sprain
A
- severe pain
- swelling
- hemarthosis
- discoloration
- unable to bear weight
- grossly positive instability test
13
Q
Management of grade 3 sprain
A
- RICE
- x-ray
- possible dorsiflexion splint
- progressive weight bearing
- isometrics in cast
- ROM exercises and balance exercises one out of cast
- possibly surgery
14
Q
Eversion ankle sprain etiology
A
-5-10%
15
Q
What is injured with an eversion sprain?
A
-deltoid ligament and possible fib fracture
16
Q
Who is more susceptible to eversion sprains?
A
-pronated and hypermobile
17
Q
Symptoms of eversion sprain
A
- severe pain
- unable to bear weight
18
Q
Management of eversion sprain
A
- RICE
- xray
- no weight bearing initially
- posterior splint
- NSAIDs
- same course of treatment of grade 2 sprain
19
Q
What can happen with grade 2 or higher sprain?
A
Considerable instability and may cause weakness in medial longitudinal arch resulting in excessive pronation or fallen arch
20
Q
Etiology of high ankle sprain
A
-external rotation and or forced dorsiflexion
21
Q
What is injured in high ankle sprain
A
- anterior/posterior tibiofibular ligaments
- sydesmosis
22
Q
Symptoms of high ankle sprain
A
- Pain anterolaterally
- loss of function
- pain
23
Q
Management of high ankle sprain
A
- difficult and longer to treat
- modified weight bearing
24
Q
Another name for high ankle sprain
A
Syndesmotic
25
Ankle fracture etiology
-blunt trauma and strong multidirectional forces
26
Symptoms of ankle fracture
- swelling
- pain
- crepitis
- deformity
27
Management of ankle fracture
- RICE
| - walking cast or brace with immobilization lasting 6-8 weeks
28
Etiology of achilles tendon strain
Common and occurs with sprains or increased dorsiflexion
29
Symptoms of Achilles strain
- pain
| - partial or complete rupture of achilles
30
Management of achilles strain
- RICE
- conservative treatment should be used to avoid chronic tendinitis
- elastic wrap
- heel lift
- stretching and strengthening
31
Achilles tendinitis etiology
- inflammatory condition
| - overload due to extensive stress
32
Symptoms of tendinitis
- pain and stiffness
- warm/ pain to touch
- tendon thickening
33
Management of tendinitis
- RICE
- NSAIDs
- long term healing time
34
Achilles rupture etiology
- sudden stop and go
| - more common in 30+ years
35
Symptoms of achilles rupture
- pain and rapidly subsides
- decreased range of motion
- swelling
- discoloration
- loss of function
- point tenderness
36
Management of achilles rupture
- RICE
- NSAID
- NWB
37
Peroneal tendon injuries
- dislocation and subluxation
- tendinitis
- similar symptoms
38
Peroneal tendon etiology
Direct blow to posterior lateral malleolus
39
Symptoms of peroneal tendon injuries
- pain
- snapping and instability
- discoloration
- swelling
- tenderness
- crepitus
40
Management of peroneal tendon injury
- RICE
- NSAID
- analgesic
- possible surgery
41
Tendinopathy/ tendinitis
Can occur in any of the tendons that cross the joint and is usually due to overuse and poor biomechanics
42
Muscle or shin contusions etiology
Direct blow
43
M/s contusion symptoms
- pain
- weakness
- swelling
- discoloration
- hard
- rigid
- inflexible
44
M/S contusion management
- RICE
- Modalities
- MAINTAIN ROM
- wrap or tape
45
Acute leg fractures etiology
- most common in fibula (mid third)
- tibial (lower third)
- direct blow or indirect trauma
46
Symptoms of acute leg fracture
- pain
- swelling
- leg hard and swollen due to increased pressure
47
Management of acute leg fractures
- splint
- xray
- reduction
- cast up to 6 weeks
48
Another name for shin splint
Medial tibial stress syndrome
49
Etiology of shin splint
- stress fracture
- repetitive micro-trauma
- 10-15% running
50
Four grades of shin splint pain
- pain after activity
- pain before and after activity
- pain before, during, after activity
- pain severe and cannot perform activity
51
Management of shin splints
- referral for xray and bone scan
- decreased activity
- biomechanics correction
- RICE
52
Stress fracture of tibia or fibula etiology
Overuse or unconditioned or non-experienced individuals
53
Symptoms of stress fx
- pain more intense after exercise
- point tenderness and percussion
- bone scan
54
Management of stress fx
- 2 weeks decreased activity
- NWB
- activity progression
55
Etiology of acute compartment syndrome
- traumatic and occurs after direct blow
| - medical emergency due to risk of neurovascular compromise
56
Acute exertional compartment syndrome
Evolves with minimal to moderate activity and non traumatic
57
Chronic compartment syndrome
Symptoms arise during activity and in lower body sports
58
Symptoms of compartment syndrome
- deep aching pain and tightness due to pressure and swelling
- reduced circulation and sensation in foot
- intracompartamental pressure measures
59
Management of compartment syndrome
- conservative: RICE and NSAIDS
- acute and severe exertional: pressure monitored
- fasciotomy for chronic condition
- surgical release patient return to activity 2-4 months
60
Rehab for injuries
- weight bearing progression
- joint mobilizations
- flexibility (achilles)
- strengthening of surrounding muscles
- proprioception
- tape/brace
- functional progression
61
What decreases likely hood of eversion sprain?
-bony protection and ligament strength decrease likelihood of injury
62
Other than eversion sprains how can the deltoid ligament be injured?
-deltoid can also be impinged and contused with inversion sprains
