First Step Evaluation of Patient with Foot and Ankle Injury

Yıl 2021, Cilt: 30 Sayı: 4, 185 - 208, 30.12.2021

Mevlana Ömeroğlu

https://doi.org/10.17827/aktd.905091

Cited By: 1

Öz

Foot and ankle injuries may be due to ligament strain or complicated and unstable distant bone fractures depending on the direction and shape of the trauma. Early diagnosis and treatment prevent complications and long-term morbidity. The specialist should take the patient’s history and determine the mechanism and nature of the trauma (recurrent or not) and post-trauma mobilization predictions to evaluate an injured foot and ankle. The trauma mechanism generally points to the possible location of the damage. Trauma size critical for determining the time it takes the injury to recover and the patient to return to work, which can be shortened by the right immobilization. Foot and ankle injuries are more common in indoor court athletes and people with reduced proprioceptive senses and restricted foot dorsiflexion. The specialist should identify preventable and modifiable risk factors and take necessary measures.

Anahtar Kelimeler

ANKLE INJURY, FOOT INJURY, LOW EXTREMİTY FRACTURES

Birinci Basamakta Ayak ve Ayak Bileği Travmalı Hastaların Değerlendirilmesi

Öz

Ayak ve ayak bileği yaralanmaları bu anatomik lokalizasyondaki bağların gerilmesinden kaynaklanabileceği gibi travmanın yönünne, şekline göre uzak kemik kırıklarına neden olabilecek komplike unstabil kırık şeklinde de olabilir. Yaralanmanın erken tanınıp uygun tedavinin uygulanması komplikasyonları ve uzun dönem morbiditeyi önlemek anlamında önemlidir. Travmatik ayak ve ayak bileği değerlendirilirken dikkatlice öykü alınmalıdır. Travmanın mekanizması, hastanın travma sonrası mobilizasyonun öngörüleri ve tekrarlayan bir travma olup olmadığı belirlenmelidir. Yaralanmanın mekanizması hasarın oluşacağı yeri genelde gösterir. Yaralanmanın boyutu, iyileşme için gereken süre ve işe dönme yeteneğini belirlemede önemlidir. Uygun immobilizasyon bu süreyi kısaltabilir. Propriyoseptif duyularında azalma, ayağı dorsifleksiyonda kısıtlılığı olanlarda, kapalı kort sporu yapanlarda ayakve ayak bileği yaralanma riski artmaktadır. Önlenebilir ve değiştirilebilir risk faktörleri belirlenmeli ve tedbir alınmalıdır.

Anahtar Kelimeler

AYAK TRAVMASI, AYAK BİLEĞİ TRAVMASI, ALT EKSTREMİTE KIRIKLARI

Kaynakça

• Vuurberg, G., Hoorntje, A., Wink, L. M., van der Doelen, B., van den Bekerom, M. P., Dekker, R., van Dijk, C. N., Krips, R., Loogman, M., Ridderikhof, M. L., Smithuis, F. F., Stufkens, S., Verhagen, E., de Bie, R. A., & Kerkhoffs, G. (2018). Diagnosis, treatment and prevention of ankle sprains: update of an evidence-based clinical guideline. British journal of sports medicine, 52(15), 956. https://doi.org/10.1136/bjsports-2017-098106
• Boyce, S. H., & Quigley, M. A. (2004). Review of sports injuries presenting to an accident and emergency department. Emergency medicine journal : EMJ, 21(6), 704–706. https://doi.org/10.1136/emj.2002.002873
• Court-Brown, C. M., McBirnie, J., & Wilson, G. (1998). Adult ankle fractures--an increasing problem?. Acta orthopaedica Scandinavica, 69(1), 43–47. https://doi.org/10.3109/17453679809002355
• Bachmann, L. M., Kolb, E., Koller, M. T., Steurer, J., & ter Riet, G. (2003). Accuracy of Ottawa ankle rules to exclude fractures of the ankle and mid-foot: systematic review. BMJ (Clinical research ed.), 326(7386), 417. https://doi.org/10.1136/bmj.326.7386.417
• Odak, S., Ahluwalia, R., Unnikrishnan, P., Hennessy, M., & Platt, S. (2016). Management of Posterior Malleolar Fractures: A Systematic Review. The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons, 55(1), 140–145. https://doi.org/10.1053/j.jfas.2015.04.001
• van den Bekerom, M. P., Mutsaerts, E. L., & van Dijk, C. N. (2009). Evaluation of the integrity of the deltoid ligament in supination external rotation ankle fractures: a systematic review of the literature. Archives of orthopaedic and trauma surgery, 129(2), 227–235. https://doi.org/10.1007/s00402-008-0768-6
• Nikken, J. J., Oei, E. H., Ginai, A. Z., Krestin, G. P., Verhaar, J. A., van Vugt, A. B., & Hunink, M. G. (2005). Acute ankle trauma: value of a short dedicated extremity MR imaging examination in prediction of need for treatment. Radiology, 234(1), 134–142. https://doi.org/10.1148/radiol.2341031060
• Fortin, P. T., & Balazsy, J. E. (2001). Talus fractures: evaluation and treatment. The Journal of the American Academy of Orthopaedic Surgeons, 9(2), 114–127. https://doi.org/10.5435/00124635-200103000-00005
• HERMEL, M. B., & GERSHON-COHEN, J. (1953). The nutcracker fracture of the cuboid by indirect violence. Radiology, 60(6), 850–854. https://doi.org/10.1148/60.6.850
• Carsen, S., Quinn, B. J., Beck, E., Southwick, H., & Micheli, L. J. (2015). "Nutcracker Fracture" in a Ballet Dancer Performing in The Nutcracker. Journal of dance medicine & science : official publication of the International Association for Dance Medicine & Science, 19(3), 124–127.
• Alan Lucerna, James Espinosa, Nicholas Butler, Ashley Wenke, Nicole Caltabiano, "Nutcracker Cuboid Fracture: A Case Report and Review", Case Reports in Emergency Medicine, vol. 2018, Article ID 3804642, 3 pages, 2018. https://doi.org/10.1155/2018/3804642
• Raikin, S. M., Elias, I., Dheer, S., Besser, M. P., Morrison, W. B., & Zoga, A. C. (2009). Prediction of midfoot instability in the subtle Lisfranc injury. Comparison of magnetic resonance imaging with intraoperative findings. The Journal of bone and joint surgery. American volume, 91(4), 892–899. https://doi.org/10.2106/JBJS.H.01075
• Kura, H., Luo, Z. P., Kitaoka, H. B., Smutz, W. P., & An, K. N. (2001). Mechanical behavior of the Lisfranc and dorsal cuneometatarsal ligaments: in vitro biomechanical study. Journal of orthopaedic trauma, 15(2), 107–110. https://doi.org/10.1097/00005131-200102000-00006
• Ross, G., Cronin, R., Hauzenblas, J., & Juliano, P. (1996). Plantar ecchymosis sign: a clinical aid to diagnosis of occult Lisfranc tarsometatarsal injuries. Journal of orthopaedic trauma, 10(2), 119–122. https://doi.org/10.1097/00005131-199602000-00008
• Armagan, O. E., & Shereff, M. J. (2001). Injuries to the toes and metatarsals. The Orthopedic clinics of North America, 32(1), 1–10. https://doi.org/10.1016/s0030-5898(05)70189-9
• Schnaue-Constantouris, E. M., Birrer, R. B., Grisafi, P. J., & Dellacorte, M. P. (2002). Digital foot trauma: emergency diagnosis and treatment. The Journal of emergency medicine, 22(2), 163–170. https://doi.org/10.1016/s0736-4679(01)00458-9