Brendan 17 year old soccer player (lateral ankle sprain) (DIALOGUISM (be…
Brendan 17 year old soccer player (lateral ankle sprain)
type of swelling and location of tenderness is consistent with ATFL sprain
pts who sprain ankles are likely to sprain again
hypermobile patients are predisposed to sprains
MOI is typical for lateral anklw sprain
be upbeat and motivating
relate RX to his goals eg soccer
liase with parents
relaxed casual manner
teenage boy, talk about sports, music and school
PROFESSIONAL SOCIALISATION ethics, values and prof identity
best practice: ensure best healing to prevent future sprains
consult his parents
liaise with his soccer coach
discuss exercises with Caitlyn
discuss goals with PJ
NARRATIVE BASED REASONING
"i stepped awkwardly off the balcony and twisted my ankle"
'since then i havent been able to walk properly'
'ice has helped the swelling'
sprained both ankles a few times
'cruise trip with family coming up in 3 weeks, need to get better'
'pain is okay now just can't walk'
DX: likely a lateral ankle sprain
compression bandage can help odema
immobilising sprained ankle should only be temporary
unstable ankles should be rehabbed with stability and strength work
ice reduces swelling and pain
ligaments respond to light controlled loading
ankles sprains should weight bear as soon as pain allows
HYPO-THETICO-DEDUCTIVE-REASONING (initial assessment)
MOI: slipped off a step and twisted ankle inward
typical lateral ankle sprain mechanism
hypermobile joints and has sprained it before
swelling, pain on weight bearing and palpation over ligaments (ATFL)
scan shows no fracture
degree of swelling and pain intensity are consistent with ligament sprain
ankle is unstable and lax compared with other side
DX: lateral ankle sprain
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