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The treatment of ankle ligament sprains (mainly lateral) depends on the severity of the sprain. Most grade I (mild) and II (moderate) sprains respond well to standard conservative measures and regain full, pain-free movement in 1–6 wks, but controversy surrounds the most appropriate management of grade III (complete tear) sprains (surgery or plaster immobilisation).
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Beware of an underlying fracture—always X-ray if doubtful.
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R rest the injured part for 48 h, depending on disability
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I ice pack for 20 mins every 3–4 h when awake for the first 48 h
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C compression bandage (e.g. crepe bandage)
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E elevate to hip level to minimise swelling
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A analgesics (e.g. paracetamol)
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R review in 48 h, then 7 d
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Use partial weight-bearing with crutches for the first 48 h or until standing is no longer painful, then encourage early full weight-bearing and a full range of movement with isometric exercises. Use warm soaks, dispense with ice packs after 48 hrs. Aim towards full activity by 2 wks.