Case Study 'Chipped Ankle bone'
This is a typical example of a direct trauma to the foot and ankle in football, as you can see from the top photo a small hole is visible where the stud of a football boot penetrated the flesh and hit the bone and chipped it.
Most of direct trauma injury cause pain, bruising, and if the skin breaks bleeding, RICE principle applies immediately and clening the wound is the priority as infection can occur.
Normally 24 hour later bruising will appear and some local swelling maybe present.
If we are in the presence of a chipped or fracture bone 24 hour later there will be a much more spread amount of swelling down to the toes as you can see from the second photo, if you compare the 2 feet you can notice the left one double sized.
Another sign of a broken bone is the patient may feel sick ( nausea) and will be very quite, i came across in 2 occasion where 2 footballers injured each other, the first one was very quite and the second one was screeming, the normal reaction is to care for the screeming one who after a bit of cold water resumed playing while the quite one had fracture the ' fibula'.
The reason a patient is quite is ' shock'.
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To be sure to be sure....advise patient to get an x-ray immediately.
The recovery time in this case was 8 weeks before resuming normal activities, no other intervention was considered other then rest.