How is ankle fracture differentiated from ankle sprain?

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

No bony point tenderness should be present; pay particular attention to the medial malleolus, lateral malleolus, base of the fifth metatarsal, and midfoot bones. Point bony tenderness at one of these areas, as well as bony deformity or crepitus, suggests the possible presence of a fracture.

The Ottawa foot and ankle rules can be reliably used to exclude fractures in children older than 5 years and has been suggested as possibly accurate for children as young as 2 years. [8, 9]

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