Author: Charlie Michaudet, MD
Co Author #1: Maren Locke, MS-3
Co Author #2: Joseph M. Wierzbicki, MD
Co Author #3: Jeffrey H. Henderson, MD, CAQSM
Brian M. Bradley, MS, AT, CSCS
Editor: Amanda Weiss Kelly, MD
The team physician and athletic training staff were called to a 15 year old female high school athlete who presented with right foot pain. While participating in spring football conditioning, a large tractor tire was flipped onto the patient’s right foot. After the tire was removed by other players, the patient noticed an obvious foot deformity with immediate swelling, severe pain, and the inability to bear weight on her right foot.
No past medical history.
No surgical history.
GEN: AAOx3, moderate-severe distress secondary to pain
CV: Tachycardic, regular rhythm, no murmurs, rubs, or gallops
RESP: CTA bilateral
MSK of right foot: Severe lateral deformity of the midfoot with significant edema extending just proximal to the ankle Case Photo #1. Tenting of the skin due to medial bony protrusion, no skin breaks. Brisk capillary refill of her five digits and 2+ pulses of her dorsalis pedis and posterior tibial arteries. Exquisite TTP over her midfoot. Her ankle and lower leg were non tender to palpation. Ankle ROM was severely limited due to pain and edema. Patient was able to move all digits.
NEURO: sensation intact bilaterally
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