Question

During a soccer match an athlete experiences a violent slide tackle to the fibula. Following examination of this traumatic orthopedic injury, the athlete is suspected to have sustained a closed non-displaced fibular fracture. After providing appropriate treatment, the sports medicine staff decide to transport the injured athlete off the field of play. However, shortly following the initial mechanism of injury the athlete begins to report increasing discomfort throughout the affected area. This continues until the athlete complains of escalating pain significantly out of context to what is expected with such a fracture.

Please answer the following questions:

1. What is the potential prognosis for this case?

2. What would be the appropriate emergency medical care/

3. What is the role of the athletic trainer in managing this situation

Answer 1

1 fibular fracture, closed, and displaced followed by increased pain , compartment syndrome symptoms, emergency medical care-fasciotomy surgery, recovery-4-6weeks, gradual walking , no difficult exercises, as per Doc sug

2 Usuallu Fibula along with tibia fractures are seen in the lower leg is seen in patients with injury on the lower leg.Usual symptoms sometimes seem to be as simple as closed, nondisplaced fracture as in the above case..However sometimes a patient may experience a sudden acute pain as in the above case.So in that case, a sports medical trainer should see for symptoms of nonbearable sudden increasing pain worsening while moving the limb, sensation, check pulse of affected limb because it may lead to a COMPARTMENT SYNDROME which is characterised by 5 P's -PAIN, PARSTHESIA, PALOR, PARALYSIS, PULSELESNESS.Compartment syndrome occurs when pressure builds up in FASCIA, a tissue that surrounds the nerves, muscles, blood vessels in the areas of body called compartments.As the pressure increases to its peak in the tissue, muscles and nerves are deprived of oxygenated blood causing permanent damage or paralyse a tissue if emergency medical care is not taken.

As a part of EMS , A Surgery called as FASCIOTOMY is done in which a small incision of skin is made to release the pressure built up inside thus restoring vascular and nervous supply to the tissues.(oxygenated blood flow).

3 Usually it takes 4-6 weeks to recover from surgery. steps such as ELEVATE your knee and ankle above the level of heart after several days of surgery, ICE-THERAPY -APPLYING ICE on the dressing for 20 min daily and preferably on the cloth or towel between ice and leg skin if dressing has been removed.

Initially weight baering activites such as brisk walking with the help of crutches can be done within the tolerable limits of pain.The task can be gradually later if no discomfort is seen.

jogging ,running swimming, cycling should be avoided and sholud be done after consulting doctor.

Presume to work when comfortable.