Ankle Injuries

This post is just show I was a proper doctor in retirement, for those who doubt.

 Ankle Injuries

Well, well, well, another dream in a series of dreams.

I was sorting out some threesomes before I drop to sleep.

In fact, I was up all night sorting out my “got to do” work and dropped to sleep briefly.

It was related an ankle injury.

Somebody known to me (cannot remember who) had a fall or had a vehicle tire run over his / her foot, came to me for treatment.

Here, I practice, RICE treatment.

REST

ICE

COMPRESSION with Crepe Bandage

ELEVATION

 

Short Form IS RICE, I added the R

and ask subject/patient to come to casualty after 24 hours for REVIEW.

In an unfamiliar or previously unknown case, I take two X-rays in perpendicular plane for comparison with the Review X-Ray done usually after 24 hours.

X-ray is done to rule out bony injuries.

Main injury is lateral ligament injury (consist of three associated ligaments, one in front, one in the middle and one behind).

Bony injuries heel without much a do, since all the bones are stabilized in a 90 degree plane but ligament injuries do cause serious instability (it takes all the body weight) of the ankle joint.

Second X-ray is done to see avulsion injury of the ligament/s (gives the severity) which shows as little calcification not immediately but after about 24 hours.

Bony injuries separated are shown in the initial X-rays and bony injuries due to compression are also visible as linear calcification lines, after 24 to 48 hours.

It does not mater it is soft tissue or bony injury, since the treatment for both is the same below knee plaster cast.

But bony injury the time of removal of the P.O.P cast is late and soft tissue injuries physiotherapy is more vigorous.

In any case plaster cast is removed and reapplied once the swelling is at its minimum.

For some unknown reason, in my dream, the standard treatment was interfered with and some altercation with the staff (not me, probably the radiographer was) followed.

Either, I did not order an X-ray (this is one of my cost saving exercises, even when working abroad-mildest form injury get only one X-ray, after 24 hours -for exclusion purposes not conclusion of more severe injury) or the VIP guy demanded one immediately and the radiographer refused without a doctors request form, which is the norm.

With this commotion I was woken up.