1/59. weight-bearing immobilization and early exercise treatment following a grade II lateral ankle sprain.STUDY DESIGN: Case study. OBJECTIVES: To describe a protocol used in the rehabilitation of a grade II lateral ankle sprain, emphasizing brief immobilization with a removable boot, weight bearing as tolerated, and progression of early exercise. BACKGROUND: The optimum conservative treatment of severe grade II ankle sprains remains undefined. Short-term benefits of early mobilization have won favor over immobilization by casting; however, pain and ankle joint instability often linger. The timing of weight bearing as a variable that influences recovery has largely been ignored when either treatment is considered. methods AND MEASURES: The patient was a 17-year-old girl who had sustained a left ankle inversion sprain while playing high school basketball. The sprained ankle was placed in an immobilizer boot for 1 week, and weight bearing was encouraged. She received instructions for active exercise and for resistive exercise with elastic tubing. Volumetric and active range of motion measurements and gait observation provided indicators of rehabilitation progress. A digital inclinometer was used to measure active range of motion in the sagittal plane. Vertical ground reaction forces recorded with an instrumented treadmill documented gait symmetry. RESULTS: The patient responded well to the course of treatment, returning to full participation in basketball 2 weeks after the injury. The injured ankle had 29% (19 degrees) less active range of motion than the nonimpaired ankle at the beginning of physical therapy. The injured ankle also displaced 50 mL more water compared with the nonimpaired ankle at the start of treatment. Four weeks after beginning treatment, the sprained ankle had 4 degrees less active range of motion and displaced 5 mL more water compared with the nonimpaired ankle. As a college athlete, the patient has remained free of subjective complaints of ankle pain, instability, and swelling. CONCLUSION: weight-bearing immobilization combined with early exercise provided safe and effective treatment for this patient, who suffered a grade II lateral ankle sprain.- - - - - - - - - - ranking = 1keywords = injury (Clic here for more details about this article) |
2/59. Osteoid osteoma of the lateral talar process presenting as a chronic sprained ankle.Pathologic conditions of the lateral talar process may be difficult to diagnose using physical examination and roentgenographs. A computed tomography scan of the hindfoot is often useful to define lesions of the lateral process. We report a case of osteoid osteoma of the lateral talar process that defied diagnosis for 4 years. The patient had an antecedent history of an inversion injury, which had been treated as a chronically painful sprained ankle without resolution of symptoms. The tumor was ultimately identified on a computed tomography scan, best seen on a coronal section through the talus. The patient had complete relief of pain after excisional biopsy of the tumor.- - - - - - - - - - ranking = 1keywords = injury (Clic here for more details about this article) |
3/59. frostbite at the gym: a case report of an ice pack burn.The case is reported of a 59 year old woman who suffered a 1% total body surface area superficial partial thickness burn to her calf following the application of an ice pack. The cause, resulting injury, and subsequent management are discussed. It is possible that such injuries are common, but no similar reports were found in a literature search. awareness of the risk of this type of injury is important for all those entrusted with advising patients on the treatment of minor soft tissue injuries.- - - - - - - - - - ranking = 2keywords = injury (Clic here for more details about this article) |
4/59. rotator cuff injuries.Different types of rotator cuff injuries frequently present to Accident and Emergency departments and minor injury units but can be difficult to differentiate clinically. This brief case study describes the examination and diagnosis of related shoulder injuries, specifically rotator cuff tears/disruption and calcifying supraspinatus tendinitis. The relevant anatomy and current therapies for these injuries is also discussed to enable the emergency nurse practitioner to have a greater understanding of the theory surrounding their diagnosis and treatments.- - - - - - - - - - ranking = 1keywords = injury (Clic here for more details about this article) |
5/59. sports related hamstring strains--two cases with different etiologies and injury sites.Hamstring strains are common injuries in sports. knowledge about their etiology and localization is, however, limited. The two cases described here both had acute hamstring strains, but the etiologies were entirely different. The sprinter was injured when running at maximal speed, whereas the hamstring strain in the dancer occurred during slow stretching. Also the anatomical localizations of the injuries clearly differed. magnetic resonance imaging (MRI) revealed pathological changes in the distal semitendinosus muscle in the sprinter and the proximal tendon of the semimembranosus muscle in the dancer. Subjectively, both athletes severely underestimated the recovery time. These case observations suggest a possible link between etiology and localization of hamstring strains.- - - - - - - - - - ranking = 4keywords = injury (Clic here for more details about this article) |
6/59. neck pain after minor neck trauma--is it always neck sprain?We report a patient who had headache and neck pain after whiplash injury and subsequently developed cerebellar infarction due to vertebral artery dissection. This patient's pain was out of proportion to his apparent injury and it was a clue to the final diagnosis. Gross motor examination for cord injury may not be adequate for patients with minor neck trauma. Detailed cranial nerve and cerebellar examination should be performed for detection of circulatory insufficiency. Discharge advice for patients should also include that of stroke or transient ischaemic attack.- - - - - - - - - - ranking = 3keywords = injury (Clic here for more details about this article) |
7/59. Pure dislocation of the ankle: three case reports and literature review.Ankle dislocation without fracture is an extremely rare injury. The results of treatment are reported for three patients who had a posteromedial open dislocation, a lateral open dislocation, and a posterior closed dislocation of the ankle. Management consisted of immediate reduction, debridement and capsular suture in the open dislocations, and immobilization with a short leg cast in all patients. At followup no patient had tibiotalar joint instability; a 10 degrees to 15 degrees loss in the range of dorsiflexion was observed in two patients. One patient reported paresthesia in the area of the superficial peroneal nerve. The three patients achieved good long-term functional and radiographic results. Predisposing factors that contribute to the pathogenesis of this lesion are internal malleolus hypoplasia, ligamentous laxity, weakness of the peroneal muscles, and previous ankle sprains. Among the three patients, medial malleolus hypoplasia was present in one patient and previous sprains were seen in the clinical history of another patient.- - - - - - - - - - ranking = 1keywords = injury (Clic here for more details about this article) |
8/59. Peroneus longus and brevis rupture in a collegiate athlete.Peroneal tendon injuries should be considered in the differential diagnosis of lateral ankle pain and instability. The spectrum of injury to the peroneal tendons includes tenosynovitis, tendinitis, subluxation, dislocation and tears. The mechanism, presentation and treatment of isolated peroneal brevis and longus injuries has been described in the literature. This is a case study of a rare combined peroneus brevis and longus injury in a young healthy collegiate athlete.- - - - - - - - - - ranking = 2keywords = injury (Clic here for more details about this article) |
9/59. A case of superficial peroneal nerve injury during ankle arthroscopy.We report a case of superficial peroneal nerve (SPN) injury caused by ankle arthroscopy. A 20-year-old woman underwent arthroscopy on her right ankle because of chronic ankle pain after a sprain. After arthroscopy, the patient complained of pain on the dorsum of her right foot and felt a radiating pain from the anterolateral portal to the dorsomedial aspect of her foot. Eight months after arthroscopy, we found that a neuroma had developed on the intermediate dorsal cutaneous nerve, and performed neurolysis of the SPN. Her symptoms gradually decreased after surgery, and had disappeared by 45 months. To avoid such an injury of the SPN, the safest placement of the anterolateral portal is necessary and is, according to our previous anatomic study, 2 mm lateral to the peroneus tertius tendon.- - - - - - - - - - ranking = 6keywords = injury (Clic here for more details about this article) |
10/59. Acute myelogenous leukaemia presenting with mid-foot pain after an inversion injury.The case is presented of a 5 year old boy who attended after an inversion injury. He had persistent pain despite treatment and was subsequently diagnosed with acute myelogenous leukaemia. It is well recognised that acute leukaemia commonly presents as non-traumatic limb pain. This case highlights the need to consider acute leukaemia in the differential diagnosis of any persisting bone or joint pain, even in the context of recent injury.- - - - - - - - - - ranking = 6keywords = injury (Clic here for more details about this article) |
| | Next -> |