FOOT AND ANKLE INJURY
DEFINITION
- Injuries to a bone, muscle, joint or ligament of the ankle and foot
Types of Injuries
- Achilles tendon rupture - There is pain in the Achilles tendon (area above heel and behind ankle). There is weakness or inability to extend the foot (e.g., can't stand on tiptoes)
- Contusion - A direct blow or crushing injury results in the bruising of the skin, muscle, and underlying bone.
- Cuts, abrasions
- Dislocations (bone out of joint)
- Fractures (broken bones)
- Sprains - Stretches and tears of ligaments
- Strains - Stretches and tears of muscles (pulled muscle).
First Aid Advice for Bleeding
- Apply direct pressure to the entire wound with a clean cloth
See More Appropriate Topic (instead of this one) If
- ANIMAL BITE to foot or ankle
- BURN of foot or ankle
- PUNCTURE WOUND to foot or ankle
- SKIN INJURY is main concern
- TOE INJURY is main concern
WHEN TO CALL YOUR DOCTOR
Call 911 now (you may need an ambulance) if:
- Major bleeding (actively bleeding or spurting) that can't be stopped.
- Limb has been partially or completely amputated
- Injury looks like a dislocated joint (crooked or deformed)
- Bone sticking through skin
- Note: For bleeding, see First Aid
Call your doctor now (night or day) if:
- You think you have a serious injury
- Severe pain
- You can't stand (bear weight) or walk
Call your doctor within 24 hours (between 9am and 4pm) if:
- You think you need to be seen
- There is a large swelling or bruise (wider than 2 inches) at the site of the injury
- You are limping
- You are over age 54, have osteoporosis, or use steroid medications routinely
Call your doctor during weekday office hours if:
- You have other questions or concerns
- Injury interferes with work or school
- Injury and pain have not improved after 3 days
- Injury is still painful and swollen after 2 weeks
Self care at home if:
- Minor bruise
- Minor strained (pulled) muscle or sprained (stretched) ligament
HOME CARE ADVICE
- Treatment of Minor
Bruise (e.g. direct blow to ankle or foot):
- Apply a cold pack or an ice bag (wrapped in a moist towel) for 20 minutes each hour for 4 consecutive hours. (20 minutes of cooling followed by 40 minutes of rest for 4 hours in a row).
- 48 hours after the injury, use local heat for 10 minutes 3 times each day to help reabsorb the blood.
- Rest the injured part as much as possible for 48 hours.
-
Treatment of Minor Sprains and Strains of Foot and Ankle:
- FIRST AID - Wrap with a snug elastic bandage. Apply an ice pack (crushed ice in a plastic bag covered with a moist towel) to reduce bleeding, swelling, and pain.
- Treat with R.I.C.E. (rest, ice, compression, and elevation) for the first 24 to 48 hours.
- REST the injured leg for 24 hours. You may return to normal activity after 24 hours of rest if the activity does not cause pain.
- Continue to apply crushed ICE packs for 10-20 minutes every hour for the first 4 hours. Then apply ice for 10-20 minutes 4 times a day for the first two days.
- Apply COMPRESSION by wrapping the injured part with a snug, elastic bandage for 48 hours. If you experience numbness, tingling, or increased pain in the injured part, the bandage may be too tight. Loosen the bandage wrap.
- Keep injured ankle or foot ELEVATED and at rest for 24 hours. Keep your foot up on a pillow and stay off your feet as much as possible.
-
Pain Medication: For pain relief, take acetaminophen every 4-6 hours
(e.g. Tylenol; adult dosage 650 mg) OR ibuprofen every 6-8 hours (e.g. Advil,
Motrin; adult dosage 400 mg).
- Do not take ibuprofen if you have stomach problems, kidney disease, are pregnant, or have been told by your doctor to avoid this type of anti-inflammatory drug. Do not take ibuprofen for more than 7 days without consulting your doctor.
- Do not take acetaminophen if you have liver disease.
- Read the package instructions thoroughly on all medications that you take.
- Expected Course: Pain and swelling usually begin to improve 2 or 3 days after an injury. Swelling is usually gone in 7 days. Pain may take 2 weeks to completely resolve.
- Call Your Doctor If:
- Pain becomes severe
- Pain does not improve after 3 days
- Pain or swelling lasts more than 2 weeks
- You become worse
And remember, contact your doctor if you become worse or develop any of the "Call Your Doctor" symptoms.
REFERENCES
- American Heart Association. 2005 Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Part 10: First Aid. Circulation. 2005;112:IV-196-IV-203.
- Bachmann LM, et.al. Accuracy of Ottawa ankle rules to exclude fractures of the ankle and mid-foot: a systematic review. BMJ. 2003;326: 417-423.
- Clanton TO, Porter DA. Primary care of foot and ankle injuries in the athlete. Clin Sports Med. 1997;16(3):435-66.
- Dake AD, Stack L. Penetrating trauma to the extremities: systematic assessment and targeted management of weapons-related injuries. Emerg Med Reports. 1997;18(7).
- Dalton JD Jr, Schweinle JE. Randomized controlled noninferiority trial to compare extended release acetaminophen and ibuprofen for the treatment of ankle sprains. Ann Emerg Med. 2006;48(5):615-23.
- Hocutt JE Jr. Cryotherapy in ankle sprains. Am J Sports Med. 1982;10(5):316-9.
- Lavery LA, Armstrong DG, Wunderlich RP, Mohler MJ, Wendel CS, Lipsky BA. Risk factors for foot infections in individuals with diabetes. Diabetes Care. 2006;29(6):1288-93.
- Markert RJ. A pooled analysis of the Ottawa ankle rules used on adults in the ED. Am J Emerg Med. 1998t;16(6):564-7.
- Stiell IG, Wells GA, Laupacis A, Brison R et.al. Implementation of the Ottawa ankle rules. JAMA. 1994;271(11):827-32.
- Wedmore I, Charette J. Emergency department evaluation and treatment of ankle and foot injuries. Emerg Med Clin North Am. 2000;18(1):85-113, vi.
Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.
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