Which clinical history is characteristic of ankle sprains?

Updated: Jan 14, 2019
  • Author: Craig C Young, MD; Chief Editor: Sherwin SW Ho, MD  more...
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Answer

The history of an ankle sprain is usually of an inversion-type twist of the foot followed by pain and swelling. Ask the patient about the mechanism of injury, as well as why, when, where, and how it occurred. Often, however, the patient's account of the mechanism does not correlate with the structures that have been damaged.

An individual with an ankle sprain can almost always walk on the foot, albeit carefully and with pain. In an individual with normal local sensation and cerebral function, the ability to walk on the foot usually excludes a fracture. Sudden, intense pain and rapid onset of swelling and bruising suggest a ruptured ligament. Suspect neurovascular compromise if the patient complains of a cold foot or describes paresthesia. [1]

Ask patients about any past ankle injuries, their goals regarding functional results, the level and intensity of their sports and activity, and their medical history. Determine the presence of any complicating conditions, such as arthritis, connective tissue disease, diabetes, neuropathy, or trauma.


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