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Hey all, hoping for some advice or assistance regarding an ankle sprain I suffered approx 10days ago. The injury was an inversion injury of my left ankle, caused by stepping in a hole whilst sprinting playing soccer. The notorious "cracking" sound was heard and I couldnt weightbear on it at all (found that one out after getting up and still trying to tackle the opposing player!!). I have had countless ankle injuries over the past 12 years of playing senior soccer, with most being on the right ankle, however this one is by far the worst I have ever seen or experienced. Apart from the fact that I still cant really weight bear on it I am more concerned with the redness present around and proximal to the lateral malleolus. Xrays were negative for fractures, no other scans etc have been done. Usual 1st aid was followed also. Anyone got any ideas or seen redness like this before, such a duration after the injury? Or am I just being too hurried in my will to return to fitness?
I have attached a couple of photos also.
Thanks in advance
Paul

http://i256.photobucket.com/albums/h...2052009236.jpg
http://i256.photobucket.com/albums/h...2052009234.jpg
http://i256.photobucket.com/albums/h...2052009233.jpg

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10 days, localized hyperemia, not too unusual.
Given the amount of swelling and the duration of symptoms and lack of x-ray findings, I predict ligament rupture.
Keep up the RICE, give it more time.
After the acute swelling and tenderness have subsided have it evaluated for occult Fx, OCD and or Lig. damage.

Good luck

Steve

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DrSArbes
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Board Certified Foot & Ankle Surgery, ABPS
Adjunct Professor OCPM
Green Bay, Wisconsin, USA

Could be a hairline fracture of the fibular that the xray didn't pick up.. Did you see the films? CT scan would do the job. Or a couple different angles on xray. Possibly unusual for a strain to cause that much swelling and redness 10 days post event. I know it is probably very painful all over, but can you isolate one area of pain more than any other?

Is the pain deep in the ankle or fairly superficial about the lateral malleolus how did the tibiofibular syndesmosis look? (sounds unlikely reading over the post again.. too late.. need sleep)

Alternatively treat as a # and see where you are in a few weeks (Rice, immobilisation consider aircast for 6 weeks??... proprioceptive)

After return to activity you could consider a lateral skive or post if you have limited calcaneal eversion, lateral STJ Axis, recurrant ankle inversion injuries. But obviously if you fall down a hole that might not do quite enough!

You probably know all this stuff, but I hope some of it helps a little..

Regards

Sam

Has anyone considered a fracture to the lateral process of the talus they are missed 40 percent of the time on standard radio-graphs.

Your symptoms seem a little bit severe for just a mild sprain i think Drsarbes is correct, and you have ligament damage.

Hi Paul, did a milder for of jamming when I stepped down on a curb outside of work. Felt the talar dome crunched severely. several weeks later fell with inversion sprain. X/Ray report stated all was well. My learned thoughts fibula and talar dome changes evident. Joint space reduced, jsut ofr starters. First U.S report some ligament tears. Vascular joint effusion. Second specialising sonographer U.S. said fibula damage with avulsion segments, torn and ruptured ligs. CT scan says 2 nicely rounded os bones. remainder fine. again my learned thoughts reduced joint space, boney changes to fib and talus. Not os bones? this is just brief rundown. Having MRI next week as still swollen, very tender. This is 3 months later having been in cam walker. My thoughts make sure you look at any tests you have. You may be able to read them better than many of those doing reports. There is a huge differnce between someone interpreting the tests who specialises in feet, than one who doesn't. Thanks Julie.
Good Luck with yours.
Heather

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Heather J Bassett
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My prediction from looking at the photos is a partial or complete tear of the anterior talo-fibular ligament and possibly also a partial tear of the inferior anterior tibio-fibular ligament. The redness is not uncommon after severe sprains. I would suggest prophylactic taping of both ankles when you are able to return to the pitch in order to avoid degenerative joint disease of the ankles in the future from your soccer (football) injuries.

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Sincerely,

Kevin

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Kevin A. Kirby, DPM
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and going one step further than the ankle taping, invest in an goog quality ankle brace for your return. ASO do a fantastic one, ive personally used their ankle brace with success in the past and it obviously doesnt weaken as the game progresses like tape does. just simply re-tighten and half time. as Kevin mentioned though, tape is more than sufficient as a propyhylactic measure.