1. ANTICIPATED MMI & RTW Roya Mirmiran, DPM, FACFAS FOOT & ANKLE TRAUMA

2. TYPES OF TRAUMA Low Energy High Energy

3. TYPES OF TRAUMA Open Fracture Closed Fracture

4. TYPES OF TRAUMA Comminuted fracture Simple fracture

5. TYPES OF TRAUMA Isolated trauma Multi-region trauma

6. Trauma of the Foot & Ankle Bone: fracture, dislocation, contusion Joint: OCD lesion, post-traumatic DJD Tendon: tenosynovitis, ruptures Ligaments: sprain or strain Nerve: neuropraxia to CRPS Others: ganglion cyst, LOK

7. Anticipated Treatment & MMI TraumaSurgeryP.T.OrthoticsMMI Small toe fracture Only if displaced NO 6 weeks Great toe fracture Only if displaced NO 8 weeks Metatarsal fractures (shaft or base) Only if 1) displaced, 2) intra-articular, 3) comminuted or 4) non-union NOYes8 weeks

8. Anticipated Return to Work TraumaSedentaryLightMediumHeavy Small toe fracture One week3-4 weeks6-8 weeks Great toe fracture One week4-6 weeks8-12 weeks Metatarsal fractures (shaft or base) One week4-6 weeks8-12 weeks4-6 months

9. Anticipated Treatment & MMI TraumaSurgeryP.T.OrthoticsMMI Lisfranc fracture- dislocation YESNOYES (A must) 6 months Talar/Cuboid fracture YES 6 months Calcaneal fracture YES (A must) 6 months

10. Anticipated Return to Work Trauma SedentaryLightMediumHeavy Lisfranc fracture- dislocation 3-4 weeks8-12 weeks4-6 months???? Talar/Cuboid fracture 3-4 weeks8-12 weeks4-6 months???? Calcaneal fracture 3-4 weeks8-12 weeks4-6 months????

11. Anticipated Treatment & MMI TraumaSurgeryP.T.OrthoticsMMI Ankle Sprain Only after conservative measures are exhausted YES Benefits from ankle brace (ASO or Ritchie brace) 3 months Ankle fracture No for a non- displaced fibular fracture, otherwise YES YES Benefits from ankle brace (ASO or Ritchie brace) 3-6 months ????? Tendon injuries Depends YES NO 2-3 months

12. Anticipated Return to Work TraumaSedentaryLightMediumHeavy Ankle Sprain1-2 weeks2-4 weeks2-3 months4-6 months with the possible use of a brace Ankle fracture1-2 weeks3-4 months4-6 months???? Tendon injuries 1-2 weeks4-6 weeks3-4 months????