Treatment of ankle sprain
Ankle sprain acute lateral ankle sprain (LAS) is a condition where the ankle joint suddenly moves to one side beyond its normal range of motion under external force, causing tearing of soft tissues such as the joint capsule, ligaments, tendons, etc. around the joint, known as ankle sprain. This type of injury typically results in damage to the lateral ligaments of the ankle joint, which typically include three ligaments: the anterior talofibular ligament, the posterior talofibular ligament, and the calcaneofibular ligament, with sprains of the lateral ankle being common.
The lateral ligament of the ankle joint is the main balancing structure on the lateral side of the ankle and an important component in maintaining ankle stability. The ankle joint is mainly fixed laterally by three ligaments: the anterior talofibular ligament, the posterior talofibular ligament, and the calcaneofibular ligament. The anterior talofibular ligament mainly deals with excessive inversion and plantarflexion of the ankle, while the calcaneofibular ligament mainly resists excessive inversion and dorsiflexion. The medial ligament of the ankle joint is called the triangular ligament, which participates in maintaining the stability of the medial side of the ankle joint
Sex, including the tibiofibular ligament, tibiofibular ligament, and tibiotalar ligament.
(Lateral ligaments of ankle joint)
The common risk factors for acute lateral ankle sprain are divided into two categories: internal factors and external factors. Internal factors: (1) limited ankle dorsiflexion range of motion (2) impaired posture control/balance (3) low BMI (lighter weight) (4) higher risk for women External factors: mainly the type of exercise. The highest incidence rate is aerobatics, basketball, volleyball, track and field and rock climbing, and the landing after takeoff is the most important risk factor. Secondly, women's love for beauty can also lead to sprains, and high heels are a key contributing factor.
Clinical manifestations: 1. Rapid pain and swelling at the twisted area after injury, followed by skin bruising. Severe cases result in the inability to move the foot due to pain and swelling. When spraining the lateral ankle, the pain symptoms worsen when attempting to perform inversion of the foot. When spraining the medial malleolus, the pain symptoms worsen when attempting to perform eversion. 2. After rest, the pain and swelling may disappear, but there may be ankle instability caused by ligament relaxation, and some patients may sprain again. Multiple repetitions may eventually develop into chronic ankle instability. 3. It seems that Xiaoliu did not pay attention to this sprain and did not undergo systematic rehabilitation, which led to the relaxation of ligaments around the ankle joint and ultimately resulted in ankle instability.
Severity grading of ankle sprain
Assessment of acute ankle sprain: 1. Exclusion of contraindications - Ottawa principle 1.1. Whether there is bony tenderness within 6cm of the medial malleolus and above; 1.2 Whether there is bony tenderness within a range of 6cm above the lateral malleolus; 1.3 There is bony tenderness in the navicular bone of the foot; 1.4 Whether there is bony tenderness at the base of the fifth metatarsal bone; Can 1.5 bear the weight and walk at least four steps.
2. Observation of edema 3. Joint range of motion examination: varus pain 4. Palpation: three ligaments (anterior talofibular ligament, posterior talofibular ligament, and calcaneofibular ligament) 5. Special tests (anterior drawer test: anterior talofibular ligament/calcaneofibular ligament test)
Before 2012, the RICE principle for emergency treatment of joint sprains advocated the application of the RICE principle, also known as the rice principle. RICE is a combination of the first letters of the English words (Rest, Ic e, Com pressure, E levation), which means "rest, apply ice, apply pressure, and lift". 1. Rest "here is not the ordinary meaning of resting the body without work or activity. It mainly refers to restricting the movement of the injured area to allow it to fully rest. In fact, it emphasizes" local braking ". Rest braking is the primary measure after any muscle, bone, or joint injury.
Mild sprains may require 3-5 days of rest to recover. But more severe injuries may take up to 3 weeks or even longer, often requiring splints, plaster, braces, etc. to protect the injured area. If the ligament is completely broken, surgical treatment may be necessary.
2. Ice compress, also known as cold compress. Ice compress shrinks the injured blood vessels, reduces bleeding, and thus reduces swelling
Inflation; Relieve pain; Relieve muscle spasms; Reduce the risk of cellular tissue damage by lowering metabolic rate. But be careful not to directly touch the skin with ice cubes during ice therapy. Wrap ice packs with towels or clothing
Then apply ice cream.
Ice packs should be used as early as possible within 24-48 hours after damage, and hot packs should not be used (hot packs can cause vasodilation and increased swelling). The duration of each ice compress is generally controlled within 15-20 minutes. Depending on the severity of the injury, it can be repeated multiple times. Hot compress can only be applied 48-72 hours after injury.
3. Compression bandaging technique generally works within 24-48 hours after injury
Using it can limit swelling in the injured area; Additional support and protection can also be provided for the injured area. During the pressure bandaging process, it is important to observe the end of the limb, such as the fingers and toes, for any pale or cold skin color. If it appears, it indicates that the bandaging is too tight and should be loosened immediately.
4. Elevating the affected limb is beneficial for reducing swelling and relieving pain. Efforts should be made to protect the injured area as much as possible
Place it above the level of the heart and use gravity to help blood flow back to the heart. It is recommended to elevate the affected limb 24/7 within 48 hours after injury.
