MSK-12 · Ankle Anatomy, Lateral Sprains, Achilles Pathology, and Compartment Syndrome

Ankle Anatomy, Lateral Sprains, Achilles Pathology, and Compartment Syndrome. Part of the Musculoskeletal series of the Reflex PM&R Board Review podcast. Audio corrections: (1) In the audio: If you are missing that 10 degrees of upward bend, you see two major compensatory movements. — Correct: The 10 degrees of dorsiflexion is a terminal-stance requirement, so the tibia can advance over the planted foot. Swing phase needs only a return to neutral for the toe to clear; circumduction and steppage appear when a contracture also costs neutral in swing. (2) In the audio: casting the ankle in a slight downward and outward position for six weeks. — Correct: An acute peroneal tendon subluxation is cast in slight plantarflexion and INVERSION for 4 to 6 weeks; inversion slackens the evertor (peroneal) tendons so the superior peroneal retinaculum can scar back to the fibula. Outward (eversion) is the wrong direction. (3) In the audio: for non-elite athletes, the functional bracing outcomes are virtually indistinguishable from surgical outcomes. — Correct: Functional outcomes are comparable for lower-demand patients, but rerupture is not: surgical repair still lowers the rerupture rate (roughly 2 to 4 percent versus 4 to 6 percent), and the largest modern randomized trial found more reruptures without surgery even with accelerated rehabilitation in both arms. The written chapter is correct. Full correction register: https://www.reflexpmr.com/errata. The full companion chapter and a linked board-style Q-bank set for this topic are at https://www.reflexpmr.com/read/MSK-12.