Roughly 85% of all acute ankle injuries are sprains; most are uncomplicated and involve only the lateral ligaments. However, there are five fractures that must be considered in the evaluation of acute ankle injuries. Of these, two occur to the proximal portion of the fifth metatarsal, and two occur to the distal third of the fibula. These are easily detectable by palpation before the onset of soft tissue swelling. Even after the onset of significant soft tissue swelling and generalized discomfort, discrete tenderness can usually be elicited at the fracture site. The fifth fracture occurs to the dome of the talus, which is located inside the ankle joint and is not accessible to detection by palpation.
All acute ankle injuries result in soft tissue trauma and swelling. Associated with these findings is loss of motion, which presents as stiffness, increased generalized discomfort, and an increased level of disability.
The timeframe between an acute ankle injury and the initial evaluation is usually sufficient for significant soft tissue swelling and the physical and functional changes to occur. This increased level of disability noted initially can lead to the assumption that the severity of the injury is greater than it is. Thus, during the history taking, it is important to obtain the level of disability at the time of the injury and shortly after.
Source: mims.com
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