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Sprains and Strains

Scott M. Goldberg, MD and J. Herbert Stevenson, MD Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Sprains are complete or partial ligamentous injuries either within the body of the ligament or at the site of attachment to bone.

    • Classified as grade 1, 2, or 3 (AMA Ligament Injury C...

DIAGNOSIS

HISTORY

  • Obtain thorough description of mechanism of injury including activity, trauma, baseline conditioning, and prior musculoskeletal injuries.

  • May describe feeling or hearing pop or snap

PHYSICAL EXAM

TREATMENT

GENERAL MEASURES

  • Acute: protection, relative rest (activity modification), ice, compression, elevation, medications, modalities (PRICEMM) therapy

  • Ankle sprains: Compression stockings didn’t af...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

If the affected joint has full strength and ROM, the patient can advance activity as tolerated using pain as a guide for return to activity. 

Patient Monitoring

Aft...

REFERENCES

1
Bendahou M, Khiami F, Saïdi K, et al. Compression stockings in ankle sprain: a multicenter randomized study. Am J Emerg Med.  2014;32(9):1005–1010. [View Abstract on OvidMedline]
2
Pete...

ADDITIONAL READING

  • Hamilton BH, Best TM. Platelet-enriched plasma and muscle strain injuries: challenges imposed by the burden of proof. Clin J Sport Med.  2011;21(1):31–36. [View Abstract on Ovi...

CODES

ICD10

  • S93.409A Sprain of unsp ligament of unspecified ankle, init encntr

  • S96.919A Strain of unsp msl/tnd at ank/ft level, unsp foot, init

  • S43.50XA Sprain of unspecified acromioclavicular joint, ini...

CLINICAL PEARLS

For acute injury, remember PRICEMM: 
  • Protection of the joint

  • Relative rest (activity modification)

  • Apply ice.

  • Apply compression.

  • Elevate joint.

  • Medications/ice for pain

  • Other modalities as ne...

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