G'day, my name's Fergus. I'm a Sports Physiotherapist. This is some clinical tests I use to diagnose injuries in my patients.
Alright, this is Ben. He was playing rugby on Saturday, a couple of days ago, and had a nasty ankle injury. Went over on it, and we think it's just a normal lateral ligament sprain. A rolled ankle. I just wanted to show you the Ottawa Ankle Rules to decide if we need to send him for an x-ray to see if it's broken.
So the first question is "could he walk on it at the time"? And he could. Ben walked off the field. Although he was limping, he could put some weight through it at the time. And a couple of days later he can put some weight through it now. So that makes me pretty happy that it's not broken. But the Ottawa Ankle Rules also say we want to feel 6cm up the posterior surface of this lateral maleoli. So the fibula's coming down the outside here, the bump on the end is the lateral maleoli,- the lateral ankle. We want to feel the back-side of this, because we know he's going to be sore at that anterior talo-fibular ligament. We want to feel the tip and the back-side of the lateral maleoli for boney tenderness to rule out a distal fibula fracture.
We want to feel the base of his 5th metatarsal to rule out an avulsion fracture of peroneus brevis - one of the muscles that attaches onto the base of the 5th metatarsal there. You can pop that off the bone and have a fracture down there. We also want to feel the posterior surface of his medial maleoli as well. 6cm up the posterior surface feeling again there for boney tenderness.
So they're the things I'm looking at for the Ottawa Ankle Rules to decide if Ben needs an x-ray, and although this ankle is big and ugly, thankfully he does not need an x-ray because we know there is no fracture.