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Ankle Injuries

Injuries to the ankle (excluding Hx of injuries)

Turf Toe Swelling and possible ecchymosis of the 1st MTP joint. Antalgic gait (toe-off occurring Laterally) Reduced or P! in ROM 1st MTP valgus or hyperextionson may cause P!
Sesamoiditis Swelling under 1st MTP Supinated foot Reduced great toe active FLEX & EXT Pes cavus or plantar-flexed first ray may be noted Antalgic gait P! when WB on 1st MTP Decreased EXT 1st MTP TTP
Hallux Valgus Obvious 1st MTP deformity w/ valgus angulation and prominene medially medial joint red and swollen pressure and irration from foot wear. Pes planus bunion may be present. more comfortable w/o shoes 1st toe abducted and may overrride 2nd LE ER in gait
Hallux Rigidus Gross deformity dorsal or medial may represent an osteophyte triceps surae atrohy may be noted if chronic relatively long 1st MTP decreased 1st MTP EXT FLEX ROM is WLN P! w/ EXT not able to stand on toes TTP of medial and dorsal aspects p!
Plantar Fasciitis Swelling over plantar medial aspect of heel. antalgic gait decrease in ankle DFlex TTP over medial calcaneal tubercle
Interdigital Neuroma No deformity possible antalgic gate WB is limited TTP P! w/ foot squeezed. Mulder Sign.
Navicular Stess Fx and Accessory Navicular no deformity medial navicular noted w/ pronated foot antalgic gait. ankle strength WNL Hopping on the involved extremity produces p!
Metataral Fx findings unremarkable possible redness over dorsal foot Swelling and increase in warmth as injury progresses Actue Fx may have obvious deformity Antaglic gait walks on lateral aspect of foot AROM and RROM might cause pain TTP callus w/ mature fx
Lateral Ankle Sprain Dysfunction porportional to injury antaglic gait decreased ROM edema, p! and muscle spasm TTP of involved Ligaments (+) Tests Anterior Drawer & Inversion Stress Test
Medial Ankle Sprain Swelling, echymosis P! and dysfunction antalgic gait unable to WB TTP of deltoid ligament Palpate distabl fibula decreased ROM (+) Special Tests: Eversion Stress test & External Rotation Test
Syndesmosis Sprain Swelling above both malleoli No WB antalgic gait Tender between tibia and fibula P! ROM w/ DFLEX and PFLEX
Ankle Dislocation Gross deformity, joint malaligment no ROM inability to WB Obvious joint disruption Fx: Lateral and medial malleoli
Peroneal Tendon Subluxation/Dislocation swelling Ambulation difficult feeling of giving way normal PFLEx and Inversion aavulsion of retinaculum palpable restricted eversion can reproduce symptoms crepitus is palpable
Retroclcaneal Bursitis PFLEX P! P! decreased w/ walking barefooted walking on toes or in high heels may increase P! p! pressure is applied to soft tissue anterior to achilles tendon increased tissue temp and swelling noted lateral to achilles tendon
Achilles Tendinitis swelling of Achilles 2-6 cm proximal to calcaneal insertion tendinitis Palpable Hamstring and triceps Surae ROM decreased difficult walking Nodule TTP P! when passive achille's tendon stretching Decrease in PFLEX Hyperprontation and decreased DFLEX
Achilles Tendon Rupture Dist. calf and achilles swelling deformity along tendon length unable to walk normal slight PFLEX Decreased ROM Positive Test: Thompson
Acute Compartment Syndrome Skin swollen vascular disruption can cause skin to appear pale or discolored P! and weakness limit the patients ability to walk p! passive elongation of muscles in involved compartment sensation over dorsal/plantar foot decreased distal pulses (-)
Chronic Functional Compartment Syndrome no outward signs present. no changes in ROM during periods of nostrenous acticity muscle weakness and p! develop during activity may alter gait Anterior compartment TTP or hard
Tibial Stress Fx mild P! during excercise mature Fx: P! in early work out & persists longer AROM and ROM WNL TTP and bony prominence palpable p! w/ low-intensity US P!/ RROM
Fibular Fx obvious diformity with displaced fx. Swelling WB possible P! with cutting activities TTP Fibular compression produces P!
Traumatic Tibial Fx Obvious deformity, swelling & muscles spasms unable to WB TTP and creoitus if non-displaced
Created by: mmorgan14
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