Ankle joint: Difference between revisions

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imported>Howard C. Berkowitz
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==Injuries==
==Injuries==
===Diagnosis===
The Ottawa ankle rules, a [[clinical prediction rule]], can indicate a possible fracture and the need for [[x-ray]]s (see [http://www.bmj.com/cgi/content/full/326/7386/417/F1 image]):<ref name="pmid11944759">{{cite journal |author=Glas AS, Pijnenburg BA, Lijmer JG, ''et al'' |title=Comparison of diagnostic decision rules and structured data collection in assessment of acute ankle injury |journal=CMAJ |volume=166 |issue=6 |pages=727–33 |year=2002 |month=March |pmid=11944759 |pmc=99451 |doi= |url=http://www.cmaj.ca/cgi/pmidlookup?view=long&pmid=11944759 |issn=}}</ref><ref name="pmid12595378">{{cite journal |author=Bachmann LM, Kolb E, Koller MT, Steurer J, ter Riet G |title=Accuracy of Ottawa ankle rules to exclude fractures of the ankle and mid-foot: systematic review |journal=BMJ |volume=326 |issue=7386 |pages=417 |year=2003 |month=February |pmid=12595378 |pmc=149439 |doi=10.1136/bmj.326.7386.417 |url=http://bmj.com/cgi/pmidlookup?view=long&pmid=12595378 |issn=}}</ref>
The Ottawa ankle rules, a [[clinical prediction rule]], can indicate a possible fracture and the need for [[x-ray]]s (see [http://www.bmj.com/cgi/content/full/326/7386/417/F1 image]):<ref name="pmid11944759">{{cite journal |author=Glas AS, Pijnenburg BA, Lijmer JG, ''et al'' |title=Comparison of diagnostic decision rules and structured data collection in assessment of acute ankle injury |journal=CMAJ |volume=166 |issue=6 |pages=727–33 |year=2002 |month=March |pmid=11944759 |pmc=99451 |doi= |url=http://www.cmaj.ca/cgi/pmidlookup?view=long&pmid=11944759 |issn=}}</ref><ref name="pmid12595378">{{cite journal |author=Bachmann LM, Kolb E, Koller MT, Steurer J, ter Riet G |title=Accuracy of Ottawa ankle rules to exclude fractures of the ankle and mid-foot: systematic review |journal=BMJ |volume=326 |issue=7386 |pages=417 |year=2003 |month=February |pmid=12595378 |pmc=149439 |doi=10.1136/bmj.326.7386.417 |url=http://bmj.com/cgi/pmidlookup?view=long&pmid=12595378 |issn=}}</ref>


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** "Bone tenderness at [[navicular bone]]"  
** "Bone tenderness at [[navicular bone]]"  
** "Inability to bear weight both immediately after the injury and in the emergency department"
** "Inability to bear weight both immediately after the injury and in the emergency department"
===Treatment===
For severe sprains, below-knee casts for 10 days may be better than compression bandages.<ref>Lamb SE et al on behalf of The Collaborative Ankle Support Trial (CAST Group) (2009). Mechanical supports for acute, severe ankle sprain: a pragmatic, multicentre, randomised controlled trial. Lancet. 373;9663:575-581. {{doi|10.1016/S0140-6736(09)60206-3}}</ref>


==References==
==References==
<references/>
<references/>

Revision as of 09:23, 13 February 2009

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In anatomy, the ankle joint is the "joint that is formed by the inferior articular and malleolar articular surfaces of the tibia; the malleolar articular surface of the fibula; and the medial malleolar, lateral malleolar, and superior surfaces of the talus"[1]

Injuries

Diagnosis

The Ottawa ankle rules, a clinical prediction rule, can indicate a possible fracture and the need for x-rays (see image):[2][3]

Ankle x-rays may be needed

  • "...if there is pain in the malleolar zone and one or more of the following:
    • "Bone tenderness at posterior edge (distal 6 cm) or tip of lateral malleolus"
    • "Bone tenderness at posterior edge (distal 6 cm) or tip of medial malleolus"
    • "Inability to bear weight both immediately after the injury and in the emergency department"

Foot x-rays may be needed

  • "...if there is pain in the midfoot zone and one or more of the following:
    • "Bone tenderness at base of fifth metatarsal"
    • "Bone tenderness at navicular bone"
    • "Inability to bear weight both immediately after the injury and in the emergency department"

Treatment

For severe sprains, below-knee casts for 10 days may be better than compression bandages.[4]

References

  1. Anonymous (2024), Ankle joint (English). Medical Subject Headings. U.S. National Library of Medicine.
  2. Glas AS, Pijnenburg BA, Lijmer JG, et al (March 2002). "Comparison of diagnostic decision rules and structured data collection in assessment of acute ankle injury". CMAJ 166 (6): 727–33. PMID 11944759. PMC 99451[e]
  3. Bachmann LM, Kolb E, Koller MT, Steurer J, ter Riet G (February 2003). "Accuracy of Ottawa ankle rules to exclude fractures of the ankle and mid-foot: systematic review". BMJ 326 (7386): 417. DOI:10.1136/bmj.326.7386.417. PMID 12595378. PMC 149439. Research Blogging.
  4. Lamb SE et al on behalf of The Collaborative Ankle Support Trial (CAST Group) (2009). Mechanical supports for acute, severe ankle sprain: a pragmatic, multicentre, randomised controlled trial. Lancet. 373;9663:575-581. DOI:10.1016/S0140-6736(09)60206-3