Sports injuries

January/February 2010

FocusSports injuries

Sports ankle injuries

Assessment and management

Volume 39, No.1, January/February 2010 Pages 18-22

Drew Slimmon

Peter Brukner

Background

Sports ankle injuries present commonly in the general practice setting. The majority of these injuries are inversion and plantar flexion injuries that result in damage to the lateral ligament complex.

Objective/s

The aim of this article is to review the assessment and management of sports ankle injuries in the general practice setting.

Discussion

Assessment of an ankle injury begins with a detailed history to determine the severity, mechanism and velocity of the injury, what happened immediately after and whether there is a past history of inadequately rehabilitated ankle injury. Examination involves assessment of weight bearing, inspection, palpation, movement, and application of special examination tests. Plain X-rays may be helpful to exclude a fracture. If the diagnosis is uncertain, consider second line investigations including bone scan, computerised tomography or magnetic resonance imaging, and referral to a sports physician. Manage all lateral ligament complex ankle sprains with ice, compression, elevation where possible and analgesia. Severe ligament sprains or rupture benefit from a brief period of immobilisation. After initial management, the athlete should complete a 6 week guided rehabilitation program. Athletes with moderate to severe lateral ankle ligament sprains should wear a semirigid or rigid ankle orthosis for at least 6 months following injury.

Concussion is a common problem in many sports and recreational pursuits, especially those involving body contact, collisions or high speeds. In general practice, concussive brain injuries may present acutely following head trauma. More commonly, patients present some time after their head injury, either with ongoing symptoms or for medical clearance to allow them to return to play. Clinical management involves confirming the diagnosis, differentiating concussion from structural head injury, estimating the severity of injury and determining when the patient can return safely to competition.

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Correspondence afp@racgp.org.au

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