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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Ankle Twisted. No Improvement Seen. Panic Stricken. No Pressure Possible. Why?

Hi, On Saturday, as I rode down a slide with my daughter (age 2), her ankle caught and twisted backwards. She cried and wouldn t put weight on it/seemed wobbly and collapsed trying to walk on it. We took her to urgent care immediately, they x-rayed, and we were told there was no obviously visiable break, so to see our regular physician/ pediatrician on Monday. We went to the Dr Monday morning, and were in and out within 5 minutes with the diagnosis that he was positive it is a sprain, unless she still won t walk on it after 2 weeks. Then it might be a fracture . My question is this: she can get around by crawling, scooting, etc., but always keeps her left foot from touching the ground. When she stands up on one foot, though, you can see the panic in her eyes at the possibility her foot may graze the floor. When she we start seeing some improvement? He didn t suggest any sort of brace or splint , but we have begun wrapping the ankle in an ace bandage to keep it in one place in the hopes she ll begin testing it after time. The Dr told us about two weeks, but we kind of assumed we would see gradual progress. She is not taking any Tylenol or anything, and doesn t seem to be in pain until she tries to support her weight on the ankle. (I can actually hold her in my lap and apply solid pressure to the bottom of her foot, and she is fine unless the ankle twists or wiggles.) Is this normal for a sprained ankle in a toddler?
Tue, 25 Mar 2014
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Orthopaedic Surgeon 's  Response
Sprains in this age group are not common but they are possible. I think the most likely diagnosis in your daughters case is a toddlers fracture of the tibia. These do not always show up straight away on X-ray and so it is worth repeating the X-ray after a couple of weeks. The treatment is a below knee cast for comfort which we usually leave on for 3 weeks or so after which time the fracture has healed sufficiently to make the leg pain free,
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Ankle Twisted. No Improvement Seen. Panic Stricken. No Pressure Possible. Why?

Sprains in this age group are not common but they are possible. I think the most likely diagnosis in your daughters case is a toddlers fracture of the tibia. These do not always show up straight away on X-ray and so it is worth repeating the X-ray after a couple of weeks. The treatment is a below knee cast for comfort which we usually leave on for 3 weeks or so after which time the fracture has healed sufficiently to make the leg pain free,