Jess has written a lot of information about the assessment and management of ankle injuries which I have uploaded as a PDF here. I have put the Ottawa ankle rules below as a taster….
The wonderful thing about ankle injuries is that there is a reliable, commonly used, validated assessment of the injury that helps you to decide if an xray is indicated. This tool was developed by a group in Ottawa, Canada and for that reason bears the name “the Ottawa Ankle Rules” which are as follows:
Carry out an ankle xray (AP and lateral) if:
- The patient could not walk 4 paces immediately after the injury OR
- The patient cannot walk 4 paces now OR
- There is bony tenderness along the posterior aspect of the lateral OR
- medial malleolus from distal tip extending up 6cm
- (or xray the foot instead if base of 5th metatarsal tenderness)
You are very welcome to carry out an xray in those who do not fit these criteria if you are worried but there is a very low likelihood of there being a bony injury.