ORTHOPEDICS■ Full range of motion
■ Normal function
■ Minimal swelling
■ Only mild localized tenderness
TREATMENT
Rest, ice, compression, elevation, elastic bandage, follow-up in 1 week if not
improved
Second-Degree Ankle Sprain
DIAGNOSIS
■ Pain with exam
■ Abnormal function
■ Moderate swelling
TREATMENT
Rest, ice, compression, elevation, elastic bandage, follow-up in 1 week if not
improved
Third-Degree Ankle Sprain
DIAGNOSIS
■ Inability to bear weight
■ Joint instability
■ Severe pain
■ Egg-shaped swelling
■ Marked functional impairment
■ Abnormal stress test
TREATMENT
If ankle is unstable, consider posterior mold and urgent orthopedic referral. If
ankle is stable but patient is unable to bear weight, rest, ice, compression, eleva-
tion, crutches, apply ankle brace, and follow up in 1 week with orthopedics.
ACHILLESTENDONRUPTURE
Commonly seen in deconditioned athletes, eg, “weekend warriors,” patients
with rheumatoid arthritis, lupus, and recent fluoroquinolone use
MECHANISM
Forceful plantar flexion against resistance
SYMPTOMS/EXAM
Often hear a “pop” during the acute injury; tenderness and a possibly a defect
2–6 cm above the insertion site to the calcaneus
DIAGNOSIS
AbnormalThompson’s test(position the patient prone with both feet extend-
ing past the edge of the table, squeeze the calf and if tendon is intact, the foot
should be plantar flexed).