Ankle And Foot Injury - Basketball

Title – Ankle and Foot Injury – BasketballAuthors 1.Dr. Nwe Win Naing (Author) – [email protected] Yee Aung (Co-author) – [email protected] Society of Physical Medicine and Rehabilitations CLINICAL CASEHISTORY: A 13-year-old student girl sustained an ankle injury while playing basketball. She had got twisted right ankle and foot injury when she landed on the ground after jumping. Severe pain, swelling and bruises were immediately appeared on the lateral aspect of the right ankle and foot. After then, she noticed that she couldn’t stand or walk properly so she went to clinic spontaneously. PHYSICAL EXAMINATION: Examination revealed swelling, redness and severe tenderness over the lateral aspect of right ankle (VAS -8). Limitation of active and passive range of motion of her right ankle joint were also presented. However, normal sensation and reflexes were observed on the injury foot. No external laceration and injuries were detected.Special Test1.Anterior drawer test – positive DIFFERENTIAL DIAGNOSIS: 1. Ankle Sprain2. Foot fracture3. Calf strain4. Achilles tendon tear TEST AND RESULTS:Right ankle and foot radiographs (Anterior-posterior, Lateral & Oblique view) — Avulsion fracture at the right 5th metatarsal tuberosity (non-displaced, comminuted fracture). FINAL/WORKING DIAGNOSIS: •Grade 2 (moderate) right Ankle sprain with avulsion fracture of right 5th metatarsal tuberosity. TREATMENT AND OUTCOMES: 1.Acute management - ice, compression, elevation (RICE), NSAIDs, analgesics. 2.Immobilization with short cast and use of crutches for 6 weeks.3.Repeat ankle and foot radiographs at 3 and 6 weeks post injury showed no delayed increase in stability.4.Toe mobilization exercises started two weeks post injury and gradually progress to putting weight on the foot after 6th week.5.After cast removal, conservative rehabilitation treatment – ROM exercises, strengthening and proprioceptive training and weight bearing exercises.6.After 3 months of immobilization, x-rays findings showed complete fracture healing and no signs and symptoms, she was allowed to return to normal activities and sports.