SUMMARY
Mieszkowski Jan, Brzezinska Paulina, Kochanowicz Magdalena, Maciejewski Jerzy, Mieszkowska Monika. Postepowanie diagnostyczno-terapeutyczne u pacjenta po skreceniu stawu skokowego – opis przypadku = The diagnosis and therapy in a patient after ankle sprains – case report. Journal of Education, Health and Sport. 2016;6(8):653-680. eISSN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.61123http://ojs.ukw.edu.pl/index.php/johs/article/view/3794 The journal has had 7 points in Ministry of Science and Higher Education parametric evaluation. Part B item 755 (23.12.2015).755 Journal of Education, Health and Sport eISSN 2391-8306 7© The Author (s) 2016;This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, PolandOpen Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium,provided the original author(s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License(http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited.This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercialuse, distribution and reproduction in any medium, provided the work is properly cited.The authors declare that there is no conflict of interests regarding the publication of this paper.Received: 05.08.2016. Revised 25.08.2016. Accepted: 28.08.2016. CASE REPORT Postepowanie diagnostyczno-terapeutyczne u pacjenta po skreceniu stawu skokowego – opis przypadkuThe diagnosis and therapy in a patient after ankle sprains – case report Jan Mieszkowski 1ABDEF, Paulina Brzezinska 2ABDEF, Magdalena Kochanowicz 3ADEF, Jerzy Maciejewski 4ADEF, Monika Mieszkowska 2DEF 1 Institute of Physical Culture, Kazimierz Wielki University in Bydgoszcz, Poland2 Poznan University of Medical Sciences, Poznan, Poland3 Faculty of Physical Education, Gdansk University of Physical Education and Sport, Gdansk, Poland4 Multi-Municipal Hospital. Dr. E. Warminski in Bydgoszcz, Bydgoszcz, Poland A – study design, B – data collection, C – statistical analysis, D – data interpretation, E – manuscript preparation, F – literature search, G – funds collection. Slowa kluczowe: skrecenie stawu skokowego, diagnostyka obrazowa, testy funkcjonalne, kinezyterapia, fizykoterapia Keywords: ankle sprain, diagnostic imaging, functional tests, kinesitherapy, physicotherapy AbstractIntroduction: Ankle sprains are classified as one of the most common injuries of the lower extremities. This type of inquiry is still frequently underestimated, both in terms of early and proper medical diagnosis and the use of fast and optimal therapeutic management.Aim: Systematization of knowledge relating to the treatment of the ankle injuries, and analyze the therapeutic treatment and its effectiveness in the ankle sprains.Case report: A case of 27-year-old patient diagnosed with left ankle injury from a prominent flooding in the area of the pond and considerable soreness and difficulties of charging.Method: Patient was twice clinical diagnosed (three weeks and two months after the injury). Gait analysis was performed; evaluation if the motion ranges in the ankle joint was performed. Assessment of the lower extremities was made basing on: Lovett’s muscle strength scale, foot functional tests (Thompson compression test, Simmond test, drawer test, two scales test). External stabilization method was used with the rail and hard tape Tapping. In addition, applied lymphatic therapy was used with kinesiology taping and lymphatic drainage method. Along with the disappearance of a patient edematous changes complex physiotherapy therapy was performed.Results: At the end of the physiotherapy cycle, re-execution of ankle tests were given. Results showed: gait isochronous, isometric and isotonic with even burdening both limbs during walking. In addition, the differences were observed in the range of the ankle motion for dorsiflexion, plantar flexion, pronation of the foot, supination of the foot, the test results of two weights test, and muscle strength of the left lower limb.Conclusions: Radiological and clinical diagnosis plays a key role in a normal therapeutic procedure for a person after ankle injury. It allows for diagnose and sets a objectives hierarchy for the optimized therapy. Comprehensive physiotherapy have a significant impact on improving of the ankle motion range, pain reduction and improvement of the functional state StreszczenieWstep: Skrecenia stawu skokowego zaliczane sa do jednych z najczesciej spotykanych urazów konczyn dolnych. Pomimo czestosci wystepowania, nadal wielokrotnie sa one lekcewazone, zarówno w aspekcie diagnostyki medycznej jak i zastosowania optymalnego postepowania leczniczego.Cel pracy: Usystematyzowanie wiedzy na temat postepowania terapeutycznego, u osoby po urazie stawu skokowego. Celem dodatkowym byla analiza postepowania fizjoterapeutycznego oraz jego efektywnosci u pacjenta po skreceniu stawu skokowego.Metoda: W pracy przedstawiono epikryze pacjenta z urazem stawu skokowego. Pacjent poddany byl dwukrotnie diagnostyce klinicznej. Wykonano analize chodu, ocene zakresu ruchu w stawie skokowym, ocene sily miesniowej konczyn dolnych przy pomocy skali Lovette’a, testy funkcjonalne stopy (test uciskowy Thompsona, test Simmonda, test szufladki, test dwóch wag). Zastosowano metody zewnetrznej stabilizacji przy pomocy szyny gipsowej, metode twardych tapów, a takze terapie ukladu limfatycznego z wykorzystaniem metody kinesiology taping i drenazu limfatycznego. Wraz z ustapieniem zmian obrzekowych, pacjenta poddano kompleksowej terapii fizjoterapeutycznej.Wyniki: Po zakonczeniu terapii chód - izochroniczny, izometryczny, izotoniczny, poprawa w zakresie: ruchu w stawie skokowym dla zgiecia grzbietowego, podeszwowego, pronacji, supinacji stopy, wyniku testu dwóch wag oraz sily miesniowej.Wnioski: W postepowaniu terapeutycznym u osoby po urazie stawu skokowego najwazniejsza role odegrala diagnostyka radiologiczna i kliniczna, pozwalajaca na postawienie wczesnej i wlasciwej diagnozy. Kompleksowe postepowanie fizjoterapeutyczne wplynelo na poprawe zakresu ruchu w stawie skokowym, zniesienie dolegliwosci bólowych oraz na poprawe stanu funkcjonalnego badanego.