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Sports Injuries Lecture 4 - Ankle Injuries

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bethdrysdale94's version from 2017-01-12 20:06

Section

Question Answer
Where do ankle inuries rank in terms of sports injuries prevalence?2nd after knee, with (11.2-20.8% prevalence)
Among ankle injuries, what is the most common sprain?ankle inversion (84%)
What games do ankle injuries have the highest prevalence?court and team sports: rugby, football, volleyball, handball, basketball
Epidemiology of ankle sprains in football 1998-200623% of all injuries, 20 days and 2 matches time lost
What are the bones of the ankle?Talus, Calcaneus, Navicular, Cuneiforms, Cuboid
What are the main joints in the ankle called?Talocrural/Tibiotalar (plantarflexion/dorsiflexion). Subtalar joint (inversion/eversion)
What proportion of weight do the tibia and fibula support?Tibia 5/6, fibular 1/6
What are the primary and secondary motions of the ankle?Plantar/dorsiflexion primary: for propulsion and locomotion. Inversion/eversion for adapting surface
What are the plantarflexor muscles and what activities are they used in?Gastrocnemius (superficial): main propellant in jumping/running Soleus (deep) constant use in prolonged standing. Together they are the triceps Surae
What are the Tibialis muscles and what are their functions?Posterior (deepest calf muscle) supports foot arch, plantarflexes, inversion. Anterior (anterior shin) main dorsiflexor, and inversion
What are the peroneal muscles and their functions?Longus (fibular) eversion of ankle, O: fibular head. I: medial cuneiform. Brevis (fibularis), less strong eversion O: fibular head
What are the toe extensors?Extensor Hallucis Longus: Big toe extension. Extensor Digitorum Longus: extends other toes
What are the toe flexors?Flexor Hallucis Longus: Big toe flexion, supports arch. Flexor Digitorum Longus: flexes other toes, helps balance by toe gripping
What are the ankle ligaments?Interosseous membrane, Anterior inferior tibiofibular ligament. Deltoid ligament (medial) Posterior talofibular ligament, Calcaneofibular ligament, Anterior Talofibular Ligament (lateral)
What were the outcomes of introducing the Ottawa Ankle Rules?100% sensitivity, moderate specificity. reduced 28% ankle and 14% foot x-rays. patients spent 36 minutes less.
What are sensitivity and Specificity?Sensitivity: True POSITIVE. Specificity: True NEGATIVE
What mechanism causes lateral ligament sprain?Inversion/supination
What mechanism causes medial sprain? (Deltoid ligament)Eversion/pronation
What mechanism causes high ankle or syndesmosis sprain?inversion & dorsiflexion
What mechanism causes tendon rupture?Forceful plantarflexion
Inversion ligament sprain diagnosis snap or pop sound, pain and swelling, fibular extends to lower position and blocks eversion, diagnosis not accurate in first five days, acute treatment for one week
What is the management of acute ankle ligamentous sprain?RICE
What is the basic anatomical grading system of lateral ankle sprains?grade 1 for one ligament, grade 2 for 2, grade 3 for all 3
What is the severity grading system for lateral ankle sprains?Grade 1: stretched, 2: partial tear, 3:complete tear/rupture
What is the anterior drawer test for ankle sprains?tests ATFL tear, ankle 10-20 degrees plantarflexed, stabilised tibia and pull foot forwards. Anterior translation indicates stability
What is the talar tilt test?CFL tear test. foot in neutral position, invert hind foot, feel for seperation of articular surface of tibia and talus
What are the tests for high ankle sprain?External rotation (knee 90 degrees, rotate foot outwards), squeeze (squeeze tibia and fibular midcalf level) and crossed leg test (put pressure on medial knee when mid leg is rested on other knee.) Pain in distal lower leg = injury
What is the management for high ankle sprain and minor fracture?Walker boot, avoid weight bearing
Achilles tendon rupturesudden onset pain, pop sound, heel swollen and bruised, unable to walk, palpable defect in tendon, weak plantarflexion, unable to lift toes, dropfoot gait
What is the Thompson test?patient face down on bed, feet off the end of bed, examiner squeezes calf muscle, foot should plantarflex. Palpate to feel achilles tendon
What are methods for achilles surgical repair?Two ends, sew them together. Break from calcaneus, drill a hole and attach.
What is the management after surgical repair of achilles?walker boot 12 weeks in plantarflexed position, adjust after time to neutral position. Start weightbearing early. Recovery as long as 6 months.
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