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Traumatology football: The Ankle Sprain

L'entorse de la cheville

It is estimated that the ankle sprain is the most common football accident.

We will incorporate some "famous injuries" in order to prove that regardless of the name or level of practice, no one is immune to injury and present a common traumatic pathology.
The ankle sprain is very often encountered during football practice, which can be repeated if a support and a serious therapeutic management are not performed in the first sprain.We trembled for ankles Thierry Henry and David Trezeguet.
Emergency services welcome every Saturday and Sunday many footballers who presented twisting rotation of the ankle with an elective pain in the outer face, swelling, to confirm the diagnosis of sprain.
The mechanism of sprain
This is most often a twisting mechanism varus or alone on uneven ground, or following a tackle or otherwise after receipt at a collective phase of play on the foot of the opponent (very common volleyball).
It is estimated that the ankle sprain is the most common football accident, predisposing factors are the poor condition of the land, unsuitable shoes to the ground, pre-existing instability, or performed poorly tackle.
What to do
The doctor will find:
  • exquisite pain on the outer side of the ankle
  • peri-malleolar edema
  • bruising (hematoma) along the outer side of the ankle
  • very painful movements in flexion extension varus valgus
The diagnosis of ankle sprain is clinical and radiological based on simple criteria:
Ottawa criteria
It exists:
  • pain on palpation of the posterior part of the outer malleolus,
  • an inability to walk immediately after the accident
  • pain out of the path of the lateral collateral ligament
In this case, one can suspect a sprain and a tear and bone removal.
Radiographic assessment must be done: face, profile, facing external rotation of the foot withFurther shots as usual ¾ external or forced.
The application in France Ottawa criteria pose a forensic problem, because it is difficult if in doubt you can without radiological assessment, confirm or not the presence of a small fracture of the external malleolus.
In this case, that one is a professional football player or simply keen sportsman, it is hard not advise carrying an X-ray that can be completed in a second time by a tendon-articular ultrasound.
Secondarily, depending on the severity of the ankle sprain, the simple immobilization can be advised by flexible strapping even laying a brace with walking ban for a period which may last three weeks.
Surgical indications
Few surgical indications are currently being asked ... Everything will depend on the degree of laxity.
In case of repetitive strain with varus greater than 15 ° or if there is a bone lesion or osteochondral associated, the surgeon can help to manage additional imaging secondarily.
Rehabilitation: proprioception
It is essential to limit recurrence and restore a sense of stability footballer.
The physiotherapist plays a critical role in the secondary prevention of ankle joint sprains and in the rehabilitation effort.
Conclusion
The lateral collateral ligament sprains ankle joint type are common among footballers. Good care associated with proprioceptive rehabilitation will limit recurrence.
Good shoes depending on the terrain, playing respecting each other and practicing tackles "clean" remains a good prevention to avoid this common accident footballer.

source
http://www.irbms.com/traumatologie-du-footballeur-lentorse-de-la-cheville

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