Apply this to the sore area for up to 15 minutes, every few hours ensuring the ice is never in direct contact with the skin. X Heavy tasks or long walks may still cause some discomfort and swellingĬold packs: A cold pack (ice pack or frozen peas wrapped in a damp towel) can provide short term pain relief. If appropriate, start the ‘Advanced exercises for sports rehabilitation’ below. You can begin to resume normal, day-to-day activities but be guided by any pain you experience. Start the exercises below labelled ‘Exercises from 6 weeks onwards’. You may want to wear it if you go on a long walk. Start around your house first and then try outside. X Try to stop using the boot and to walk without crutches. Perform the exercises below regularly to get your movement back. It is ok to take the boot off at night and when resting at home. Use the crutches to take some of the weight off of your foot. Wear the boot all of the time when walking. If you are worried that you are unable to follow the rehabilitation plan, or have any questions, then please phone the Fracture Care Team for advice. Should you need to re-schedule this appointment please contact us. This is at the Royal Sussex County Fracture Clinic ( see map). Your appointment will have been scheduled on your phone call. We therefore recommend a repeat weight-bearing x-ray and clinical review with our Extended Scope Physiotherapist at approximately 2 weeks after your injury. There is a small chance that this type of fracture may displace (move). You will find it easier to walk with crutches in the early stages. You may walk on the foot as comfort allows. The boot you have been given is not needed to aid fracture healing but will help with your symptoms and should be worn whenever you’re walking. Pain and swelling can be ongoing for 3-6 months. The swelling is often worse at the end of the day and elevating it will help. This normally takes approximately 6 weeks to heal. Use the video or information below to gain a better understanding of your injury and what can be done to maximise your recovery. National Football League ankle fracture athlete deltoid ligament football instability return to play syndesmosis.This information will guide you through the next 6 weeks of your rehabilitation. The majority of NFL players treated surgically for this injury pattern are able to return to play after surgery with no reported complications or persistent medial ankle pain or instability. Superficial deltoid complex avulsion during high-energy ankle fractures in athletes is a distinct injury pattern that should be recognized and may benefit from primary open repair. There were no intraoperative or postoperative complications noted, and no players had clinical evidence of medial pain or instability at final follow-up with radiographic maintenance of anatomic mortise alignment. Average playing experience after surgery was 1.6 seasons, 16 games played, and 15 games started. Average playing experience before surgery was 3.3 seasons, 39 games played, and 22 games started. There were no significant differences in playing experience before surgery versus after surgery. Return to play was defined as the ability to successfully participate in at least 1 full regular-season NFL game after surgery.Īll NFL players were able to return to running and cutting maneuvers by 6 months after surgery. Patient demographics were recorded with position played, time from injury to surgery, games played before and after surgery, ability to return to play, and postoperative complications. Surgical treatment for all patients consisted of ankle arthroscopy and debridement, followed by fibula fixation with plate and screws, syndesmotic fixation with suture-button devices, and open deltoid complex repair with suture anchors. Average time from injury to surgery was 7.5 days. Player positions included 1 wide receiver, 1 tight end, 1 safety, 1 running back, 1 linebacker, and 9 offensive linemen. Average age for all patients was 25 years and body mass index 34.4. Patients with chronic deltoid ligament injuries or ankle fractures more than 2 months old were excluded. We found that there is often complete avulsion of the superficial deltoid complex off the proximal aspect of the medial malleolus during high-energy ankle fractures in athletes.īetween 20, the cases of 14 NFL players who underwent ankle fracture fixation with open deltoid complex repair were reviewed. The purpose of this descriptive case series was to analyze the preliminary outcomes of acute superficial deltoid complex avulsion repair during ankle fracture fixation in a cohort of National Football League (NFL) players. Infolding and retraction of an avulsed deltoid complex after ankle fracture can be a source of persistent increased medial clear space, malreduction, and postoperative pain and medial instability.
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