Initial treatment of ankle injuries

Any significant ankle injury must be evaluated by a health care provider, who should use the Ottawa Rules as discussed in yesterday’s blog to determine whether xrays are indicated in ruling out a break.  Serious fractures are generally repaired urgently by an orthopedic surgeon or a podiatrist.                                                                                                                                                                                                                                       For the vast amount of injuries, however, the initial treatment goal is to reduce swelling.  This applies both to simple fractures and sprains.  The acronym RICE refers to what should be done initially after an injury…Rest, Ice, Compression and Elevation.  A patient should keep off the ankle with the use of crutches, usually for the first 48 to 72 hours.  Ice should be used intermittently, an elastic bandage should be snugly applied and the ankle should be elevated above the heart as much as possible.  Once the swelling is down, a walking boot or cast is applied if there is a fracture, and range of motion and strengthening exercises with gradual weight bearing are started if there is a sprain.  A physical therapist is very important in supervising the rehabilitation of an injured ankle, as the incidence of  weakness and reinjury is higher in an ankle that is not properly treated…Richard R. Samuel, MD     Family Practice and Urgent Care