Ankle, Sprained or Broken?

In clinic, I often see several patients a week with a sprained ankle. It can be difficult, even for us providers, to determine whether or not the ankle is broken. Fortunately, we can order an Xray to determine clearly if it is a break, rather than a sprain. Unfortunately, when the world comes to an end you probably won't know anyone who stocked up on X-ray machines. I want to share with you the steps we take as providers to determine if an ankle is a broken or only sprained. Now this is not 100% accurate, but it tends to be about 95% accurate in determining the likelihood of a break. These rules can be followed with minimal medical experience.

The Ottawa Ankle Rules. These rules were developed years ago by some Canadian doctors and have been used ever since by providers around the world. I wouldn't advise to rely on these if you feel you need medical attention, please seek it out if you have a bad sprain. These rules will help determine if you have a broken leg or ankle and need early immobilization to prevent further damage.

Suspect a broken leg if you have ANY of these finding:

Rule 1 - There’s tenderness when you press on the tibia along any part of the six centimeters (about two-and-a-half inches) above where it ends.

Rule 2 - There’s tenderness when you press on the fibula along any part of the six centimeters above where it ends.

Rule 3 - You’re not able to bear any weight because of ankle pain.

Suspect a broken foot if you have ANY of the findings:

Rule 1 - There’s tenderness when you press near the ankle on the fifth metatarsal.

Rule 2 - There’s tenderness when you press on the navicular bone anywhere. (Press the top of it or its inner side.)

Rule 3 - You’re unable to bear weight due to foot pain.

If it is determined you have a broken foot or leg, immobilization is key. Using a SAM splint or branches from a tree, immobilize the entire ankle to allow healing, and then if available, seek help from a medical professional. If you do not immobilize the joint, further damage can occur, which may then need surgical repair. Surgery during an apocalypse means you are S.O.L my friend. So good luck out there fellow preppers.