Makindo Medical Notes

🦴 BT = Bone tenderness. 🤕 Treat sprains with RICE (Rest, Ice, Compression, Elevation, + Analgesia). 📉 The Ottawa Ankle Rules reduce unnecessary X-rays by up to 25%.

📋 Ottawa Ankle Rule Criteria

ℹ️ Additional Notes

• ✅ Ottawa Ankle Rules are highly sensitive (~100%) for ankle & midfoot fractures → helps rule out fracture safely.
• ❌ Do not apply in:
  • Multiple injuries, head injury, or intoxication.
  • Peripheral neuropathy / reduced sensation.
  • Strong suspicion of stress fracture (often subtle & not tender acutely).
• 🔎 If swelling & pain persist after 5–7 days → repeat assessment (occult fractures may later become visible).

🛠️ Management of Ankle/Foot Sprains (RICE Protocol)

• 🛑 Rest: Limit weight-bearing, crutches if required. Resume activity gradually as pain allows.
• 🧊 Ice: Apply 15–20 min every 1–2 hrs for first 48 hrs to reduce pain/swelling.
• 🩹 Compression: Elastic bandage/ankle support. Must be snug but not restrictive to circulation.
• 🦵 Elevation: Keep above heart level especially first 24–48 hrs to reduce swelling.
• 💊 Analgesia: NSAIDs or paracetamol; NSAIDs also reduce inflammation.

📤 When to Refer

• 🔧 Suspected high ankle sprain / syndesmotic injury (positive squeeze test).
• ⏳ No improvement after conservative management, or persistent instability.
• ⚠️ Neurovascular compromise OR severe functional limits beyond 2–6 weeks recovery window.