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9.12 Ligament Sprains (Including Joint Capsule Injuries)


Presentation

A joint is distorted beyond its normal anatomical limits (as when an ankle is inverted or a shoulder is dislocated and reduced) The patient may complain of a snapping or popping noise at the time of injury, immediate swelling, and loss of function (suggestive of second- or third-degree sprain or a fracture); or he may corne in hours to days following the injury, complaining of gradually increasing swelling and resulting pain and stiffness (suggestive of a first- or second-degree sprain and development of a traumatic effusion).

What to do:

What not to do:

Discussion

Ligamentous injuries are classified as first-degree, (minimal stretching); second-degree (a partial tear with functional loss and bleeding but still holding); and third-degree (complete tear with ligamentous instability, often requiring a cast). A tense joint effusion will limit the physical examination (and is one reason to require re-evaluation after the swelling has decreased) but also suggests less than a third degree ligamentous injury, which is normally accompanied by a tear of the joint capsule.

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from Buttaravoli & Stair: COMMON SIMPLE EMERGENCIES
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Craig Feied, MD
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