Careers: EMT/Emergency Medical Technicians/ankle

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Question
Question. My 14 y/o suffered an ankle injury during his soccer game. There was immediate swelling and he was unable to bear weight. He took him to be seen within 30 minutes. The x-ray come back as “soft tissue swelling” but no fractures seen. We elevated, iced, rested, ect. Four days later I took him to see an orthopedist. She did an exam and she thought the ankle was broke or fractured, as well. She did an x-ray, spent a significant amount of time reviewing it on the spot and could not find and breaks or fractures. She sent us home in an air boot and stated he could walk in this boot if tolerable. He has little to no pain, except upon palpitation of the ankle. The ankle does remain a bit swollen but virtually no bruising ( unlike mine in the past).  We are to return in 14 days for a follow up and additional x-ray. The ortho stated she wasn’t going to do a MRI because, she would treat a severe sprain and hairline fractures the same anyway. My question is this. After two X-rays, one read by an orthopedist, wouldn’t a fracture be visible? Sorry to be long winded.

Answer
Hello Slayde,

Sometimes an initial X-ray can be hard to read because of tissue swelling. There is also a variable of how the X-ray was taken, too light, too dark, movement... I suppose additional X-rays after walking on the injury could show new findings as muscle use and weight pull on possible fractures. I'm not an expert on X-rays so I can't really tell you more. I hope this answer helped. I hope he gets better soon.

Marc

Careers: EMT/Emergency Medical Technicians

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Marcus LaBarbera

Expertise

I am available to answer most questions related to: first aid, pre- hospital medicine, EMT and Paramedic questions, CC-EMTP Course offered through UMBC, medical transport, critical care transport, ICU/CCU care, sedation, and medicine in general.

Experience

I have worked as a NYS Paramedic since 1993 for both community based ambulance companies and large commercial agencies. I Have experience as bike team commander, and shift supervisor for a commercial ambulance. As a member of the Disaster team I was deployed to Louisiana for 20 days following hurricane Katrina. I worked along side the county Haz-Mat team as a "Tox-Medic" with advanced training in treating injuries from chemical agents. Besides my experience on the on the ambulance I have worked in a number of hospital based offices including dialysis and a sleep lab.

Education/Credentials
I started my EMS career as a NYS CFR (Certified First Responder)in 1989, an EMT in 1991, a Paramedic since 1993, and a CCU transport paramedic since 2005. I currently hold certification as a: NYS Paramedic, Critical Care Transport Paramedic, ACLS/CPR/PALS certified. Advanced Haz-Mat Life Support certified (AHLS). In the past I have taught CPR and ACLS to my coworkers and the local community.

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