Have I Fractured My Ankle Or Foot?

A lot of us injure our ankles by twisting it or somebody landing on it. It gives us immediate pain, blows up the size of a football and we always have that niggling question.... is it more than just a ligament or soft tissue injury? Have I fractured my ankle or foot? Today, we discuss 3 clinical signs which clinicians at the hospital will assess for. Now, first things first. If under ANY doubt, please seek urgent medical attention. Now... the 3 clinical signs come from the Ottawa Ankle Rules a set of guidelines for clinicians to help decide if a patient with foot or ankle pain should be offered X-rays to diagnose a possible bone fracture. The rules have a specificity rating of 98.5% (as conducted by medical professionals) so are very accurate in deducing the need for an ankle xray, or not! Before the introduction of the rules most patients with ankle injuries would have been imaged. However the vast majority of patients with unclear ankle injuries do not have bone fractures. As a result, many unnecessary X-rays are taken, which is costly, time consuming and a health risk due to radiation exposure. An Ankle X-ray is only required if: 1) Bone tenderness along inside ankle bone (at the rear edge) upwards 6cm. OR...Bone tenderness along the outside of the ankle bone (at the rear edge) upwards 6cm. 2) Pain or tenderness on navicular bone or 5th metatarsal (see video!) 3) An inability to bear weight both immediately and in the emergency department for four steps. .... and naturally, if there is any new painful lumps of bone on the inside of the ankle (malleolar) zone. A foot X-ray series is indicated if: There is any pain in the midfoot zone; and any one of the following: 1) Bone tenderness at the base of the fifth metatarsal (for foot injuries), OR Bone tenderness at the navicular bone (for foot injuries), (SEE VIDEO!) 2) An inability to bear weight both immediately and in the emergency department for four steps. It must be noted that certain groups are excluded, in particular pregnant women, those with diminished ability to follow the test (for example; head injury or intoxication). Several studies strongly support the use of the Ottawa Ankle Rules in children over 6 (98.5% sensitivity). However, their usefulness in younger children has not yet been thoroughly examined. The original rules were developed for ankle and foot injuries only, but similar guidelines have been developed for other injuries such as the Ottawa knee rules Recommendations: Ensure to apply the Ottawa Ankle Rules accurately by... 1) Completing the tests in the video 2) Using the rules only on those over the age of 18 3) Be sure to give written instructions and encourage follow-up in 5-7 days if pain and walking ability have not improved. ======================================= Have an injury? Speak with us today at: www.theonlinephysiotherapist.com/contact-us-2/ See our other videos and blogs for more info on how to live a healthy life and avoid injury at: www.theonlinephysiotherapist.com/blog ======================================= Related Videos: ======================================= How To Treat Shin Splints Using ONLY A Tennis Ball https://youtu.be/_g8pVcoAt4U Release Your Neck And Shoulder Muscles With A Tennis Ball: https://youtu.be/jS-XnwyhcWg Tennis Ball Self-Massage for Your Glutes and Piriformis: https://youtu.be/l3flN43z-EQ Self-Release of Pec Tightness With A Tennis Ball: https://youtu.be/3mCyDqfNnqY ======================================= Our Running Series: https://youtu.be/Hv8TgfB-IKI Our Ankle Series: https://youtu.be/BLLzPZ-MCUg ======================================= SUBSCRIBE for the Latest Videos: https://www.youtube.com/channel/UCUeKSCpoJ8T7PGq8IWaIyDw ======================================= Tim Barsellotti is an Advanced Physiotherapist and Founder of The Online Physiotherapist. http://www.theonlinephysiotherapist.com http://www.facebook.com/theonlinephysio1 https://www.instagram.com/theonlinephysiotherapist/ https://www.linkedin.com/company/theonlinephysiotherapist https://twitter.com/thephysioonline ======================================= DISCLAIMER: This content (the video, description, links, and comments) is not medical advice or a treatment plan and is intended for general education and demonstration purposes only. This content should not be used to self-diagnose or self-treat any health, medical, or physical condition. Don’t use this content to avoid going to your own healthcare professional or to replace the advice they give you. Consult with your healthcare professional before doing anything contained in this content. You agree to indemnify and hold harmless The Online Physiotherapist Ltd and its officers for any and all losses, injuries, or damages resulting from any and all claims that arise from your use or misuse of this content. The Online Physiotherapist Ltd makes no representations about the accuracy or suitability of this content. Use of this content is at your sole risk.