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Abstract

Background: Ankle fractures, specifically unilateral fractures, are among the most common injuries encountered by orthopedic surgeons. Ankle fractures have an incidence of 187 out of 100,000 individuals. Current treatment options for ankle fractures are dependent on stability of the ankle mortise, determined through number of fracture sites and ligamentous integrity. The management of the fracture scan either be surgical or nonsurgical, the majority being surgical. In this case report, a 17-year-oldmaleoutside linebacker sustained a left lateral ankle injury during a regular season football game. As he attempted to make a tackle, his left foot got caught in the turf, he fell backwards, and heard a pop. He continued to play in the game, but the pain progressively got worse. Upon halftime evaluation, the injury was deemed a lateral ankle sprain and the student-athlete (SA) was taped for external support. The SA could no longer ambulate. The SA was given crutches post-game and returned to the athletic training room the next day for further evaluation. The tuning fork test, squeeze test, and bump test were all positive, but only 2 out of 5 criteria for Ottawa Ankle Rules were met. Differential Diagnosis: Differential diagnoses include lateral ankle sprain, lateral malleolus fracture, and subluxation of peroneal muscle. Treatment: The SA was given a walking boot and referred to a physician for imaging. Radiographic images showed a minimally displaced, left lateral malleolus fracture. The SA was referred back to the athletic training room to complete a rehabilitation program. After 7 weeks of rehabilitation working on regaining range of motion, strength, proprioception, and neuromuscular control, the SA was cleared for participation and was able to play in the last football game of the season. Uniqueness: Most lateral ankle fractures are treated surgically, but because there was no displacement or ligamentous disruption in this case, the fracture was treated nonsurgically. Conclusion: Minimally displaced lateral ankle fractures that are treated nonsurgically have excellent outcomes. A thorough examination and evaluation is vital in overall ankle management. The best rehabilitation program depends on a lot of factors, but the stability and mobility of the ankle should be considered along with the pain levels with weight bearing, time elapsed from injury, bone quality, and risk factors for healing. While radiographic imaging is the gold standard when fractures are suspected, examination findings by an athletic trainer can play an important role in identification and triage.

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