Summer - United States Special Operations Command

More documents

Recommendations

Info

In testing for stability of the ATFL, which is amajor stabilizer of the ankle, an anterior drawer test isperformed. This is done much like the anterior drawertest of the knee. The knee is flexed to 90 degrees andthe foot is stabilized (Figure 61). By applying an anteriorlydirected force to the calcaneus, or by stabilizing thefoot, and then applying a posteriorly directed force to thetibia, the stability of the lateral ankle ligaments are tested.Figure 63: Torn ATFL with posterior tibia and fibula subluxation.Although xray stress views are shown for teachingpurposes, the posterior “clunk” as the bones sublux isreadily felt and may be visualized in most patients.Figure 61: Anterior drawer test of the ankle. With aposteriorly directed force applied to the tibia, and withthe foot stabilized, there is no subluxation of the tibiaand fibula posterior on the talus.If the ATFL is torn, the tibia and fibula will subluxposteriorly (Figure 62 and 63). It should be notedthat this test should always be performed with the kneeflexed. With the knee extended, there is false stabilitywhen doing the test.The treatment for an ankle sprain is to preventthe deforming forces of plantarflexion and inversion.This is performed by taping the ankle followed by administrationof non-steroidal anti-inflammatory medication.Further evaluation upon return to base isabsolutely required. Most likely the mission can becompleted.ANKLE TAPINGJust as with the knee, the taping at the ankle beginswith applying anchoring strips. The anchoringstrips are usually overlapped by approximately 30-50%.This taping method is demonstrated using two colors oftape so that the overlap and position of the tape may bebetter appreciated. As with taping the knee, the skinshould be clean and dry. If possible, shave the hair priorto tape application. However, tape should NOT be appliedover open wounds.Start by placing the ankle in the neutral position,perpendicular to the lower leg (Figure 64).Figure 62: Torn ATFL with posterior tibia andfibular subluxation on the talus after applyinga posteriorly directed force.Figure 64: Start with the ankle perpendicular to theforeleg and everted if possible.2Journal of Special Operations Medicine Volume 9, Edition 3 / Summer 09
The circumferential anchoring strips are appliedwith approximately a 30%-50% overlap (Figure65). Strips are applied at the metatarsal phalangeal regiondistally as well as approximately half way up theforeleg.Figure 67: Second hindfoot anchoring strip applied.Figure 65: Proximal and distal anchoring strips.Following the basic anchoring strips, U-shapedstrips are applied. When applying these strips, startproximally and medially. As the tape is applied, thehindfoot is pulled into eversion, to decrease the stresson the damaged ATFL region. This allows for stabilityof the ankle with respect to inversion and eversion (Figure66 and 67).After two of these strips have been applied,U-shaped strips are applied beginning at the medialaspect of the foot and then continuing posterior to theankle, ending at the distal lateral aspect of the foot.This aids in stability of forefoot adduction and aids instability of inversion (Figure 68 and 69).Figure 68: Initial horizontal foot/ankle anchoring strip.Figure 66: Pull tape strips from medial to lateral toevert the hindfoot.Figure 69: Second horizontal foot/ankle anchoringstrip.Field Evaluation and Management of Non-Battle Related Knee and Ankle Injuries by the ATP in theAustere Environment — Part Three3
Page 1 and 2: Volume 9, Edition 3 / Summer 09 Jou
Page 3 and 4: An 18D deworms a camel during a “
Page 5: Field Evaluation and Management of
Page 9 and 10: In doing so, all the skin is closed
Page 11 and 12: NATO SOF Transformation and theDeve
Page 13 and 14: current and future operations, thes
Page 15 and 16: sion of a physician, and limited pr
Page 17 and 18: REFERENCES1. James L. Jones, “A b
Page 19 and 20: This article is the first of two me
Page 21 and 22: Figure 4 : A Special Forces medic c
Page 23 and 24: exposure. Conversely, the customary
Page 25 and 26: 7. Ted Westmoreland. (2006). Attrib
Page 27 and 28: first three days of injury, althoug
Page 29 and 30: 9. Markgraf CG, Clifton GL, Moody M
Page 31 and 32: the only sign of OCS may be elevate
Page 33 and 34: E. The canthotomy allows for additi
Page 35 and 36: 33. Rosdeutscher, J.D. and Stradelm
Page 37 and 38: Tinnitus, a Military Epidemic:Is Hy
Page 39 and 40: The development of chronic NIHL pro
Page 41 and 42: supplied by diffusion. During expos
Page 43 and 44: similar to those of other authors,
Page 45 and 46: promising effect on tinnitus. Howev
Page 47 and 48: ADDITIONAL REFERENCESHoffmann, G; B
Page 49 and 50: et al. demonstrated that both right
Page 51 and 52: TYPICAL CHEST RADIOGRAPH FINDINGS I
Page 53 and 54: 11. Norsk P, Bonde-Petersen F, Warb
Page 55 and 56: ABSTRACTS FROM CURRENT LITERATUREMa
Page 57 and 58:
tourniquet times are less than 6 ho
Page 59 and 60:
tal from July 1999 to June 2002. In
Page 61 and 62:
Operation Sadbhavana: Winning Heart
Page 63 and 64:
CENTRAL RETINAL VEIN OCCLUSION IN A
Page 65 and 66:
of the X chromosome. Notable is tha
Page 67 and 68:
AUTHORS*75th Ranger Regiment6420 Da
Page 69 and 70:
Casualties presenting in overt shoc
Page 71 and 72:
PSYCHOLOGICAL RESILIENCE AND POSTDE
Page 73 and 74:
spondents without PTSD (M = 4.6, SD
Page 75 and 76:
patients, whereas the mean score of
Page 77 and 78:
29. Whealin JM, Ruzek JI, Southwick
Page 79 and 80:
average, time between return from d
Page 81 and 82:
ing functioning in both PTSD (Zatzi
Page 83 and 84:
Editorial Comment on “Psychologic
Page 85 and 86:
Blackburn’s HeadhuntersPhilip Har
Page 87 and 88:
The Battle of Mogadishu:Firsthand A
Page 89 and 90:
Task Force Ranger encountered enemy
Page 91 and 92:
Peter J. Benson, MDCOL, USACommand
Page 93 and 94:
Numerous military and civilian gove
Page 95 and 96:
Anthony M. Griffay, MDCAPT, USNComm
Page 97 and 98:
This is a great read that speaks di
Page 99 and 100:
and twenty-eight. Rabies immune glo
Page 101 and 102:
Rhett Wallace MD FAAFPLTC MC SFS DM
Page 103 and 104:
LTC Craig A. Myatt, Ph.D., HQ USSOC
Page 105 and 106:
LTC Bill Bosworth, DVM, USSOCOM Vet
Page 107 and 108:
Europe, Mideast, Africa and SWAU.S.
Page 109 and 110:
SOF and SOF Medicine Book ListWe ha
Page 111 and 112:
TITLE AUTHOR ISBNCohesion, the Key
Page 113 and 114:
TITLE AUTHOR ISBNI Acted from Princ
Page 115 and 116:
TITLE AUTHOR ISBNRats, Lice, & Hist
Page 117 and 118:
TITLE AUTHOR ISBNThe Healer’s Roa
Page 119 and 120:
TITLE AUTHOR ISBNGuerilla warfare N
Page 121 and 122:
TITLEAUTHORBlack Eagles(Fiction)Bla
Page 123 and 124:
TITLE(Good section on Merrill’s M
Page 125 and 126:
GENERAL REFERENCESALERTS & THREATSB
Page 127 and 128:
Aviation Medicine Resources: http:/
Page 129 and 130:
LABORATORYClinical Lab Science Reso
Page 131 and 132:
A 11 year old boy whose tibia conti
Page 133 and 134:
Meet Your JSOM StaffEXECUTIVE EDITO
Page 135 and 136:
Special Forces Aidman's PledgeAs a
show all

Summer - United States Special Operations Command

Create successful ePaper yourself

Delete template?

Save as template?