Ver el código de «Ankle sprain»

==Background==
===Ankle stabilization anatomy===
[[File:919 Ankle Feet Joints.jpg|thumb|Ligaments of ankle and feet.]]
*Syndesmosis
*Ligaments
**Medial: Medial collateral (deltoid) ligament (tibia to talus and calcaneus)
**Lateral: Anterior/posterior talofibular, calcaneofibular ligaments

==Clinical Features==
[[File:Schwellung am Fußknloechel und Blutergussl.jpg|thumb|Right foot with acute lateral ankle sprain.]]
===Lateral Ankle Sprain===
*Most common
*Due to inversion of plantarflexed ankle
*Anterior talofibular ligament (ATFL) is most commonly injured ligament

===Medial Ankle Sprain===
*Isolated sprain is unusual; often associated with fibular fracture or syndesmosis injury
*Always rule-out [[Maisonneuve]] fracture by evaluating proximal fibula

===Syndesmotic Sprain ("High-ankle sprain")===
*Associated with with hyperdorsiflexion when talus moves superiorly and separates tibia/fibula
*Pain just above talus

==Differential Diagnosis==
{{Other ankle injuries DDX}}

{{Distal leg fractures DDX}}

{{Foot and toe fractures DDX}}

==Evaluation==
*Anterior drawer test
**Tests anterior talofibular ligament
**Cup heel with one hand and and pull anteriorly while pushing tibia posteriorly
*Talar tilt test
**Tests for combined injury of anterior talofibular and calcaneofibular ligaments
**Inversion at the ankle causes tilting/lifting of the mortise joint
===Imaging===
{{Ottawa Ankle Rules}}
{{Ottawa Foot Rules}}
====Exceptions====
*Age <6 or >55
*Only for blunt trauma mechanism
*Does not apply to subacute/chronic injuries
*Does not apply to injuries of the hindfoot or forefoot

===Classification===
*Grade I
**No tearing of ligaments
**Minimal pain, swelling, ecchymosis; weightbearing is tolerable
**No splinting/casting; weight bearing as tolerated, isometric exercises, full ROM and stretching/strengthening exercises
*Grade II
**Partial ligament tear; possible instability
**Increased pain, swelling, ecchymosis; difficulty bearing weight
**Immobilize with air splint; PT with ROM/stretching/strengthening exercises
*Grade III
**Complete ligament tear; significant instability
**Severe pain, swelling, ecchymosis; inability to bear weight
**Immobilization and possible surgery; PT same as grade 2 but longer time period

==Management==
*Stable joint and ability to bear weight: (Likely Grade I)
**[[NSAIDs]], RICE (rest, ice, compression, elevation)
**1 week follow up if no improvement
*Stable joint but unable to bear weight or unstable joint (Grades II and III) :
**Ankle cast immobilization or a removable walking boot for 7-10 days for grades II and III. Follow up at 5 days with ortho/podiatry. <ref>[https://www.podiatrytoday.com/guide-conservative-care-ankle-sprains Douglas Richie, A Guide To Conservative Care For Ankle Sprains. Podiatry Today Volume 29 - Issue 7 - July 2016]</ref>	
**[[Splinting#Lower Extremity|Posterior mold splint]] and ortho consult/referral

==Disposition==
*Discharge

==See Also==
*[[Ankle (Main)]]
*[[Ankle Fracture]]
*[[Ottawa Ankle Rules]]

==References==
<references/>

[[Category:Orthopedics]]
[[Category:Sports Medicine]]