Date of Award

2015

Document Type

Scholarly Project

Degree Name

Doctor of Physical Therapy (DPT)

Department

Physical Therapy

First Advisor

Michelle LaBrecque

Keywords

Ankle Fractures -- rehabilitation; Conservative Treatment; Fractures, Avulsion -- rehabilitation; Case Reports

Abstract

Background and Purpose: Ankle and foot injuries are common for all age groups, no matter the activity level. Ankle and foot injures can include strains, sprains, and/or fractures in any combination which can be debilitating for ambulation and functional activities. The most common foot fracture is an avulsion of the fifth metatarsal base, also called a Jones fracture, often associated with forced inversion of the foot. Almost all patients will return to their prior ambulatory state with proper care and rehabilitation within 12-16 weeks. The purpose of this scholarly project is to show the rehabilitation of a Jones fracture in an elderly female with emphasis on a structured strengthening, stretching and manual therapy program.

Methods/Case Description: The patient was a 69 year old female presenting to physical therapy two months post left lateral ankle sprain and fifth metatarsal avulsion fracture. The patient slipped out of her wedge type shoes while walking down her driveway. Radiographs confirmed the avulsion fracture of her fifth metatarsal. The physician elected not to perform surgery and prescribed an immobilizing boot for four weeks.

Findings/lnterventions: Based on her diagnosis and examination findings, a rehabilitation program was developed to address her impairments of range of motion (ROM) and strength deficits, swelling, pain and gait abnormalities to progress her toward her prior level of function (PLOF).

Outcomes: The patient showed consistent improvements throughout her rehabilitation including a decrease in swelling and pain and an increase in range of motion, strength and functional capacity.

Discussion/Conclusion: The patient was able to return to her PLOF with normal ankle strength and ROM, no edema and no assistive device or gait deviations within 11 physical therapy visits. This case report shows that rehabilitating a severe ankle injury, including a fracture and sprain, should include a thorough strengthening and stretching program to allow a patient to return to their PLOF.

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