Doctors Lounge - Orthopedics Answers
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Forum Name: Bone trauma and fractures
|mortgageguy - Wed Jul 25, 2007 11:57 pm|
So a good friend of mine rolled his ankle in our soccer game last night. once he rolled it, he didnt continue to play, and he barely put any weight on it. today, it looked like this...
obviously he needs to be seen by a doctor (currently doesnt have health insurance, so is hesitant), as i have been telling him since yesterday. I've been an EMT-I for 6 years, and i've seen less severe-looking injuries end up being breaks. he can move it, but barely. I was hoping that someone with more orthopaedic experience could take a peek at the picture, and share your thoughts. thanks!
|Dr. Chan Lowe - Thu Jul 26, 2007 2:50 am|
Unfortunately the picture isn't coming through for me. Perhaps I can give you some advice without it though. Several years ago a group of physicians developed the Ottowa Ankle Criteria to help determine when an x-ray should be done on an ankle with these type of injuries.
An x-ray should be performed if:
1) there is point tenderness over the medial or lateral maleolus (the bones of the bottom of the lower leg where they stick out).
2) There is point tenderness over the lateral edge of the foot (over the 5th metatarsal)
3) There is point tenderness over the navicular bone (on the medial aspect of the foot near the back side of the arch).
4) The patient was unable to bear weight immediately after the injury AND the patient cannot bear weight for 4 steps when being evaluated.
If any of these are present an x-ray should be done as the possibility of a fracture is higher.
If these are not present a fracture is less likely but not definitively ruled out. In these cases, an x-ray may still be appropriate if the clinician feels there are signs of a break.
It can take several days for an ankle injury to really seem like it is getting better. If your friend's ankle is not improving I would agree with you that he should be evaluated.
|mortgageguy - Thu Jul 26, 2007 8:58 am|
thanks for the info... try this for the pic (not that it really makes a difference)
|Dr. Chan Lowe - Mon Jul 30, 2007 11:03 pm|
It's hard to say but given the extent of the bruising there certainly may be a fracture. If he's still having pain he should have it checked out (if he hasn't already).
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