martes, 28 de marzo de 2017

Examen clínico del tobillo



Clinical Examination of Ankle

Fuente
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Courtesy: Prof Nabil Ebraheim, University of Toledo, Ohio, USA
Dr. Ebraheim’s educational animated video describing fractures of the ankle, Clinical examination, Educational video describing fractures of the ankle X-rays.
It describes ankle fracture classification, ankle fracture dislocation.
It also describes ankle fracture treatment and ankle fracture surgery and ankle fracture recovery.
You look for the circulation, diabetes, peripheral neuropathy.
Make sure that the patient doesn’t have Charcot- fracture or Charcot- joint, as this is very important.
Look also for the soft tissue condition; you may want to delay the surgery until soft tissue condition improves.
You want to do elevation.
Try to identify if there is any open fracture.
Try to reduce the dislocation, try to improve the position of the fractures and splint the patient.
There are 2 points related to clinical exam that is worth mentioning:
1- Clinical exam is unreliable in predicting the medial injury; so if you have swelling, tenderness, or ecchymosis, it’s not reliable in predicting medial injury, you probably need to get stress views, to see if the deltoid ligament is injured or not.
2- If the patient has tenderness over the medial malleolus and unable to bear weight, and the patient is older, get an x-ray, this is not an ankle sprain, this may be a fracture.
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