ABSTRACT
The athlete presents with severe ankle pain, usually on the lateral side of the ankle, following a twisting injury or a direct blow. Swelling is rapid. Marked deformity may be obvious. Weight-bearing may be possible, depending on the severity of the injury. If severe deformity is apparent, the limb may be moved into a more normal position (reduced) by applying longitudinal traction, pulling the foot distal as an assistant holds the athlete’s knee in 90° of flexion. Emergent reduction of these severely deformed ankles is recommended to reduce tension on stretched neurovascular structures. The athlete is removed from play, the limb is splinted and elevated, and the athlete is transported for further evaluation and management.
