Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with acute onset of severe ankle pain, swelling, and inability to bear weight following high-energy trauma/axial loading injury. Reports localized tenderness over the talus, ecchymosis, and mechanical block to subtalar motion. No reported neurovascular deficits or open wounds.
Clinical Examination Findings
Physical exam reveals significant edema and ecchymosis around the malleoli and hindfoot. Point tenderness elicited over the talus. Range of motion is severely restricted due to pain. Neurovascular status: distal pulses (DP/PT) are palpable and symmetric; capillary refill <2 seconds; sensation intact to light touch in all dermatomes; no motor deficits in toe flexion/extension.
Treatment Protocol
Immediate immobilization in a posterior splint with non-weight-bearing status. Ice, elevation, and analgesia initiated. Radiographic evaluation (AP, lateral, and oblique ankle views) performed; CT scan ordered for definitive fracture mapping and assessment of articular displacement. Orthopedic consultation for surgical vs. non-surgical management based on fracture classification (Hawkins).