Ankle Injury

“The only joints I roll are my ankles! ”

— unknown

Take away points

Ankle injuries can present on a spectrum
For in more significant fractures, consider the MOI involved and what injuries could be occult. A common concominant fracture is a head of fibular injury.
open fractures with neurovascular compromise need to reduced and splinted appropriately. Remember this NV compromise can be quite subtle, so assess for it properly.
prophylactic antibiotics, but dont forget to check for allergy
less severe injuries should be assessed using a look, feel, move approach.
assess the joints above and below the injured one for concominant injury.
just becuase its swollen doesnt = fracture, but bare in mind the absence of swelling isnt on its own reassuring either.
ottowa ankle = imaging decision tool, not presence of fracture tool. If positive they will require an XR but this doesnt = ambulance transport, consider other options if appropriate.
for sprains and soft tissue injuries we need to give first aid advice, protect and rest it, but gentle motion in the following days. Ice can be helpful in the immediate hours after the incident but only 20 minutes at a time.
dont forget analgesia plan, paracetamol will normally suffice. evidence is unclear on ibuprofen so possibly avoid if the patient will tolerate it.