The posterior splint is on the left. The sugar tong (or stirr-up) splint is on the right. An ankle stirrup splint would provide better immobilization, since it protects against inversion-eversion and to some degree also protects against a fair degree of flexion-extension.The stirrup splint can also be combined with the posterior splint to provide maximal immobilization and protection against further trauma to the injured ankle. Patients should be told to refrain from weight-bearing (use crutches) and to elevate the injured extremity as much as possible.

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2. Textbook of Pediatric Emergency Medicine, Third Edition. Baltimore, Williams & Wilkins, 1993, pp. 259-267.Harris JH, Harris WH, Novelline RA. The Ankle (Chapter 14). In: The Radiology of Emergency Medicine. Williams & Wilkins, 1993, pp. 966-1009.Jackson JL, Linakis JG. Ankle and Foot Injuries. In: Barkin RM, et al (eds).
3. Pediatric Emergency Medicine: Concepts and Clinical Practice. St. Louis, Mosby Year Book, 1993, pp. 366-375. Pigman EC, Klug RK, Sanford S, et al. Evaluation of the Ottawa clinical decision rules for the use of radiography in acute ankle and midfoot injuries in the emergency department: An independent site assessment.
4. Ann Emerg Med 1994;24;41-45. Reisdorff EJ, Cowling KM. The injured ankle: New twists to a familiar problem. Emerg Med Reports 1995;16;39-48. Simon RR, Koenigs SJ. The Ankle (Chapter 30). In: Emergency Orthopedics, The Extremities, Third Edition. Norwalk, Appleton & Lange, 1995, pp. 477-489. Stiell IG, McDowell I, Nair RC, et al. Use of radiography in acute ankle injuries: Physician's attitudes and practice.
5. Can Med Assoc J 1992;147:1671-1678.Stiell IG, McKnight RD, Greenberg GH. Decision rules for use of radiography in acute ankle injuries: Refinement and prospective evaluation. JAMA 1993;269:1127-1132. Swischuk LE. The Extremities (Chapter 4).
6. In: Emergency Imaging of the Acutely Ill or Injured Child, Third Edition. Baltimore, Williams & Wilkins, 1994, pp. 528-548.

Copyrighted:Radiology Cases in Pediatric Emergency Medicine Volume 3, Case 3 Loren Yamamoto, MD, MPH Associate Professor of Pediatrics University of Hawaii John A. Burns School of Medicine loreny@hawaii.edu

Last created on 12-04-2001
Last modified on 01-07-2006