Foot/Ankle and Lower Leg Fractures and Dislocations Injuries, Part 2 Foot/Ankle and Lower Leg Fractures and Dislocations

“Before & After” BELLWORK Using a piece of notebook paper, answer the following questions, leaving a line between each answer. Put the paper aside until the end of class. 1. How do you get a fracture? 2. How do you get a dislocation? 3. What does a fracture look like? 4. What does a dislocation look like?

Objective Differentiate between common injuries and their mechanisms, signs, symptoms and treatments.

PROPERTY OF PIMA COUNTY JTED, 2010 Idea Wave List 3 - 5 ideas about the injuries that were examined yesterday. Be ready to share. After the “Idea Wave,” be prepared to rank your top three ideas from the class. 33. Idea Wave each student lists 3 to 5 ideas about the assigned topic the teacher calls on a non-volunteer to begin the "idea wave" by sharing one idea the student to the right of the first non-volunteer shares one idea; then the student to the non-volunteer’s right shares one idea the teacher directs the flow of the "idea wave" until all different ideas have been shared by asking each student at the end of the formal "idea wave," students will rank their top 3 ideas PROPERTY OF PIMA COUNTY JTED, 2010

Dislocations Rare in ankle, but common in phalanges MOI: S/S: Rx: http://blogs.openaccesscentral.com/blogs/jfars/entry/closed_posteromedial_dislocation_of_the http://fiveprime.org/hivemind/Tags/toe,xray Rare in ankle, but common in phalanges MOI: Traction or twisting S/S: Deformity Possible fractures Inability to move extremity Rx: Immobilize Cold Referral for reduction or Emergency Action Plan (EAP)

Acute Fractures MOI: S/S: Direct blows Twisting Associated with avulsions/dislocations S/S: Localized Pain Deformity? Swelling Ecchymosis Crepitis Pain with WB dailymail.co.uk

Acute Fractures- Specialties Avulsion Fractures Common for ATF Ligament to fracture lateral malleolus (looks like 3rd Degree sprain) Jones Fracture- Peroneus brevis pulls off proximal 5th metatarsal with forced inversion Growth Plate (Epiphyseal) Fractures Distal plated in fibula and tibia may fracture with inversion/eversion

Jones Fracture

Acute Fractures Stress Tests: Rx: Tap Test- tibia, fibula, talus or calcaneus Calf squeeze/compression- tibia or fibula Rx: RICE Referral for x-ray Be prepared to activate Emergency Action Plan (EAP) if open fracture or signs of shock

Stress Fractures Extremely common due to repetitive action S/S: point tenderness; especially in WB position Rx: NWB (non-weight bearing) > week or more Walking boot or cast possible Out of activity 3-4 weeks Gradual resumption of activity

Tibial Stress Fracture This was picked up on a bone scan: http://tech.snmjournals.org/content/35/2/64/F8.expansion

March Fracture Stress Fracture to metatarsals due to repetitive activity empowher.com

“What’s My Injury?” With a partner, choose an injury from today’s lesson Write a creative scenario about that injury including the etiology, pathology, and treatment for the injury Be prepared to share with the class

“Before & After” CLOSURE On your Before and After bellwork sheet, answer the following questions on the line below your “Before” answers. This will assess your new learning for the day! 1. How do you get a fracture? 2. How do you get a dislocation? 3. What does a fracture look like? 4. What does a dislocation look like?