Ankle sprain

Template

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DiagnosisChoose oneTitle

LateralityChoose oneFirst line

SeverityChoose oneFirst line

ExamChoose one

ImagingChoose one

SupportChoose one

PlanChoose any

CrutchesChoose any

Return to sportsChoose any

ReferralChoose any

Follow-upChoose one

Counseling

Most ankle sprains improve over 1-3 weeks, with swelling and bruising settling first. Recommended supportive care with tylenol or motrin as needed for pain, with an emphasis on ice, elevation, using the support during activity, and the home exercises. Return precautions given including pain or swelling that is getting worse, numbness, a cold or pale foot, not able to bear weight, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.

CounselingNot in the note with these choices

Most ankle fractures in children heal well with protection, and orthopedics will guide the cast or boot and return to activity. Recommended supportive care with tylenol or motrin as needed for pain, with an emphasis on elevation, keeping the splint dry, and using the crutches. Return precautions given including pain or swelling that is getting worse, numbness or tingling, a cold or pale foot, a splint that feels too tight, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.

Note when inserted as is

Ankle sprain
• Neurovascularly intact without deformity
• No x-ray needed by the Ottawa ankle rules
• Ankle brace
• Ice, compression, elevation, and weight bearing as tolerated
• Home exercises for motion, strength, and balance as pain allows
• Gradual return to sports after running, cutting, and jumping without pain
• Follow up if not improving in 1-2 weeks

Most ankle sprains improve over 1-3 weeks, with swelling and bruising settling first. Recommended supportive care with tylenol or motrin as needed for pain, with an emphasis on ice, elevation, using the support during activity, and the home exercises. Return precautions given including pain or swelling that is getting worse, numbness, a cold or pale foot, not able to bear weight, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.

What the sources cover

Laterality, severity
Neurovascular status, deformity
Ottawa rules; x-ray negative; physeal tenderness; fracture
Brace, wrap, boot, splint
RICE, weight bearing as tolerated; rehab exercises
Functional progression before sports

Return precautions in the template

pain or swelling that is getting worsenumbnessa cold or pale footnot able to bear weight

Sources

Sport-Related Concussion in Children and Adolescents. Clinical Report. Pediatrics 2018;142(6):e20183074. (newest AAP concussion CR found; also Early Childhood…
Overuse Injuries, Overtraining, and Burnout in Young Athletes. Clinical Report. Pediatrics 2024;153(2):e2023065129. (replaces earlier report)
Early Childhood Concussion. State-of-the-art review. Pediatrics 2024;154(5):e2023065484 (not an AAP policy)

Few formal guidelines cover this topic, so the template also leans on expert opinion.