Talk:Sprained ankle

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References[edit]

Removed alot of very poorly referenced material and tagged other stuff. --Doc James (talk) 19:35, 23 December 2008 (UTC)

Icing an ankle too long may cause cold injuries.[citation needed][edit]

Do we really need a citation for this..? Ice kept on too long causes cold injuries. It's common sense, what do you think can happen exactly? 93.33.245.206 (talk) 18:06, 21 April 2009 (UTC)

Yes a good idea to keep it many believe more is better and thus the freeze injuries.--Doc James (talk · contribs · email) 21:07, 27 May 2009 (UTC)
Logically, you're going to get frostbite-style damage if you freeze tissue. It would be could to get some sort of citation for that. BTW, I've come to this page because I twisted my ankle a few minutes ago. It’s swollen up like a balloon. I hobbled over to the computer to learn what to do about it. — Chameleon 08:34, 26 July 2009 (UTC)

Merge?[edit]

Any idea why this article is separate from the more generic Sprain? Are sprained ankles really that different that sprains in general?

Yes one is a specific condition the other is far more general. Doc James (talk · contribs · email) 17:51, 16 July 2010 (UTC)

Proposed merge[edit]

I propose that this article be merged into Sprain because the differentiation of an ankle sprain from a sprain in general is not so great as to rate a separate article. WikiDan61ChatMe!ReadMe!! 17:45, 8 February 2010 (UTC)

Proposal abandoned due to lack of support. WikiDan61ChatMe!ReadMe!! 17:30, 5 April 2010 (UTC)
Disagree. As they are discussed separately in the literature.Doc James (talk · contribs · email) 17:49, 16 July 2010 (UTC)

A good ref[edit]

[1] --Doc James (talk · contribs · email) 17:49, 16 July 2010 (UTC)

I would like some advice on my ankle[edit]

Hi, I would like some advice on my ankle I am in an airbase at the moment and anyone who knows alot about the subject and could give me some advice I would be glad as I'm confused with what's actually wrong with it as it's mega bad, can show anyone pics for their opinion Cheers — Preceding unsigned comment added by 26sameaves (talkcontribs) 00:24, 14 March 2011 (UTC)

Use of word 'Sensitivity' under 'Diagnosis' section[edit]

Sensitivity is a measure of true positives Specificity is a measure of true negatives, this is what is described under the diagnosis section following the use of the above word, the word should be specificity not the sensitivity... I have therefore changed this word from sensitivity to specificity. —Preceding unsigned comment added by 86.150.64.98 (talk) 23:10, 17 March 2011 (UTC)

Thanks for checking this, but after double checking at the Sensitivity and specificity article, I think the proper word is still "sensitivity". Highly sensitive tests have low false negative rates, which is what the sentence describes. The cited article also states that the test is highly sensitive and therefore useful as a way to prevent unnecessarily order radiographs on people who almost certainly do not have ankle fractures. mcs (talk) 02:37, 18 March 2011 (UTC)

Hi, thanks for your reply, I have not changed the article back, however do still believe you to be wrong. You state that "highly sensitive tests have a low false negative rate", this is not strictly true. Highly sensitive tests have a high true positive rate. A low false negative rate = a high true negative rate = specificity. A high true positive rate = a low false positive rate = sensitivity. The degree of true positivity is all you can talk about them when refering to sensitivity - its exclusively a measure of how accurate the positve predictive value is. If a test with a high sensitivity shows something is positive, then it is very likely to be positive, however, if that same test shows something to be negative, it may not be so accurate. - Specificity determines how likely this is. How high or low the false negative rate is is specificity. —Preceding unsigned comment added by 86.150.64.98 (talk) 20:44, 18 March 2011 (UTC)

Hi. Thanks for not changing the article back, for your contribution to wikipedia, and for your very polite disagreement. Right now, the sensitivity article states outright "A test with a high sensitivity has a low type II error rate." The article on type II error says "Type II error, also known as an "error of the second kind", a β error, or a "false negative": the error of failing to reject a null hypothesis when in fact we should have rejected it. In other words, this is the error of failing to observe a difference when in truth there is one, thus indicating a test of poor sensitivity" Those seem to be more consistent with my interpretation, no? I also question your assertion that "low false negative rate = a high true negative rate = specificity". Say I have a test that returns "positive" no matter what. This test has a 0 false negative rate and a 0 true negative rate. mcs (talk) 00:05, 19 March 2011 (UTC)

Hello again, further to your most recent points I have come to realise this: Firstly you are right (the sensitivity of the Ottawa ankle rules is high) as referenced by this article "http://www.bmj.com/content/326/7386/417.full" however your above reasoning for why the correct term is 'sensitivity' remains incorrect. I realise my issue is now not with the word used, but with the description provided. The article currently, and incorrectly states:

"It has a sensitivity of nearly 100%, meaning that a patient who tests negative, according to the rule almost certainly does not have an ankle fracture"

I accept the sensitivity is high however would submit that the correct way of illustrating this point in similar terms to the above would be by saying:

"It has a sensitivity of nearly 100%, meaning that a patient who tests positive, according to the rule, almost certainly does have an ankle fracture"

I believe this to be the true definition of sensitivity and the above two statements whilst similar are not the same. I will attempt to demonstrate why using your cited example of type 1 and 2 errors:

You state a type 2 error is failing to observe a difference when in reality there is one, which is true. The article claims a patient who tests negative almost certainly does not have a fracture. This description suggests there is a low occurrence of a patient testing negative and being told they don't have a fracture when they do. This is a type 1 error corresponding to specificity, not a type 2 error as described by you above. I'm afraid I don't understand your last point, if you have a test that returns positive no matter what, then a negative rate is never provided so you can't compare true and false negatives. Your false/true negative rate will be determined by how accurate this test is at predicting a negative value. If it predicts negative values well, the true negative rate will be high and the false negative rate will invariably be low - this is all I was saying. As your test never predicts a negative value, there is no data on the truth or falsity of these negative predictions with which to compare, and you can't compare two things that don't exist. —Preceding unsigned comment added by 86.144.94.33 (talk) 11:34, 19 March 2011 (UTC)

Ok. We'll I'm glad we can agree on what the citation says at least, and I'll admit that wasn't the best example. Unfortunately, I don't understand your explanation about the type II error. The definition of type II error that I was trying to emphasize is "false negative", but I can see that wasn't helpful.
How about this: the worked example in the sensitivity and specificity article, under "Related calculations" states flatly "False negative rate (β) = ... = 1 − sensitivity". Thus high sensitivity implies low false negative rate. Does that convince you? mcs (talk) 15:57, 19 March 2011 (UTC)


Review article[edit]

  • Tiemstra, JD (2012 Jun 15). "Update on acute ankle sprains.". American family physician. 85 (12): 1170–6. PMID 22962897.  Check date values in: |date= (help)Doc James (talk · contribs · email) (if I write on your page reply on mine) 14:39, 12 September 2012 (UTC)

Movement Anatomy[edit]

What's up movement anatomy guys! BarneyStinson13 (talk) 18:16, 12 February 2013 (UTC)

New information for Rehabilitation of Ankle sprains[edit]

Hey guys, I added some valuable information that could help people with sprained ankles regain their strength and ability. Jackhammer out! — Preceding unsigned comment added by Jackhammer21 (talkcontribs) 18:19, 12 February 2013 (UTC)

Citation for "inadequate shoe heel support" causing sprains?[edit]

Citation might be needed here, or the comment pulled. There seems to be no peer-reviewed research supporting that any shoe can cause or prevent a specific injury. In addition, heel-cushioned shoes would seem to act in opposition to three of the other ultimate causes of ankle injury mentioned: stronger ankles, inadequate joint proprioception, and slow neuron muscular response to an off-balance position. — Preceding unsigned comment added by 199.126.224.207 (talk) 02:22, 19 August 2013 (UTC)

Unreferenced, inaccurate information for removal[edit]

There is this 'advice' under 'Conservative Measuares': If the ankle is not swollen, if it just hurts to walk on and has limited mobilization, it is generally recommended that the injured person wears an orthopedic walking boot for two weeks and is on crutches for the first week at least. There is no reference for this, and the information is highly inaccurate. Unless a reference can be provided for it ( and I cannot find one), I propose this be deleted. Does anyone have any comments on this? 86.172.33.142 (talk) 21:27, 5 August 2014 (UTC)

I just came here investigating the same claim as suspicious. It doesn't match anything else I can find on the topic. Since it's unreferenced and you now challenged it more than 6 months ago, I'm just going to remove it. Thanks, User:Glenn Willen (Talk) 20:22, 16 February 2015 (UTC)

Why RICE?[edit]

Lots of places say rest, icing, compression, elevation is the right treatment, mostly to lower the risk of further injury and reduce swelling. But .. why is reducing swelling important? There must be a doctor on Wikipedia who can speak to that. Here is a long article with references basically saying it is an open question: http://skeptics.stackexchange.com/questions/27328/why-should-we-try-to-reduce-swelling-after-injury. dfrankow (talk) 16:37, 10 December 2015 (UTC)