Author: Jason Zaremski, MD
Co Author #1: Brian J Krabak, MD MBA
Clinical Associate Professor
Rehabilitation, Orthopaedics and Sports Medicine
University of Washington and Seattle Children’s Sports Medicine
National Team Physician, USA Swimming
Medical Director, RacingThePlanet 4 Desert Ultra-marathons
Seattle, Washington
Patient Presentation:
A 16 year-old male soccer player suffered a non-contact injury while attempting to kick a soccer ball.
History:
The player had his left leg planted and externally rotated when he felt a pop from his left ankle. Immediately he felt pain in the left ankle and had difficulty weight-bearing. He was evaluated at the community emergency room and diagnosed with a distal fibula fracture on x-ray. He was then placed in a posterior splint and discharged. The next day, he followed-up at our sports medicine clinic due to worsening symptoms.
Physical Exam:
Physical examination revealed distal lower extremity swelling. The patient was unable to bear weight on the left leg, but he had an intact neurovascular examination. There was tenderness to palpation over the distal tibia, fibula and deltoid ligament.
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