意大利整骨Pathophysiology 3.3宣讲培训.pptVIP

Pathophysiology through clinical cases- Leg and Foot -CLINICAL CASE 3;Patient Presentation A 17-year-old female high school volleyball player presents in the emergency department with severe ankle pain and swelling History During a volleyball match, she jumped to block an opponent’s hit and landed on the opponent’s foot, “rolling” her ankle In the 2 hours since the injury, her ankle has become progressively swollen and dark Physical Examination Considerable edema of the entire ankle region Large hematoma on the lateral aspect of the ankle Severe ankle pain, regardless of foot position Pain exacerbated with pressure over lateral malleolus Positive anterior drawer test of ankle;Situation in which the ligaments of the ankle have been overstretched but not completely ruptured With severe sprains, the pain may be so intense that walking is not possible and the ankle shows signs of instability Signs and Symptoms Sensory Deficit Ankle pain Other Deficits Swelling Bruising, ecchymosis Ankle instability in severe cases, with positive anterior drawer test Predisposing Factors Participant in activities that require jumping, because at the end of the jump the ankle is plantar flexed (and therefore least stable) to allow the forefoot to have initial contact;The most common type of lateral malleolar fracture because the ligaments that attach the fibula to the tarsal bones are very strong The mechanism for this injury is the same as for ankle sprain and the anterior talo-fibular ligament is the most frequently involved one Distinguishing ankle sprains from fractures requires a thorough evaluation of ankle range of motion and radiographic imaging is needed except in case of mild sprains Unimalleolar fractures account for 70% of ankle fractures, and the majority of these involve the lateral malleolus Signs and Symptoms Sensory Deficit Ankle pain Other Deficits Swelling Bruising, ecchymosis Positive anterior drawer test Predisposing Factors Participant in activities that require