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Ankle inversion injury - Coggle Diagram
Ankle inversion injury
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pathophysiology
- haemorrhage and inflammation
retraction of ends of disrupted ligaments causes increased blood flow and vascularity, forms a blood clot between disrupted ends, clot is reabsorbed and replaced by a heavy cellular infiltrate
- matrix and cellular proliferation
hypertrophic fibroblastic cells produce scar tissue to bridge gap between disrupted ends, it is initally disorganised but gradual alignment over time
- remodelling and maturation
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classification
Grade 1
mild sprain, few damaged fibres, mild bruising and swelling, can weight bear
good prgnosis, 1-3 weeks recovery
Grade 2
partial tear, significant bruising/swelling, discomfort when weight bearing
more tissues damage/scar tissue, 3-6
Grade 3
ruptured, very tender and swollen, not necessarily more painful than G2 but very unstable
longer, maybe surgery, high chance of Chronic Ankle Instability (CAI)
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subjective assessment
PC
location of symptoms, SIN factors, 24 hours, eggs/eaes
HPC
mechanism of injury, treatment to date, first occurrence?
PMH
health, prev injuries, THREADS
DH
meds, impact on healing eg steroids
SH
home, work, hobbies, participation
physical assessment
observation
antalgic gait, posture, alignment, skin appearance (CRPS)
physiological ROM
muscle testing (isometric, OMG), active and passive but build to resisted ROM, PERONEI, GASTROC, SOLEUS
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treatment
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regain ROM (auto assisted, mechanical etc )
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weight bearing and proprioception, unstable surfaces