Your Patient Sustained a Fracture of the Right Calcaneus as the Result

question 15

Multiple Choice

Your patient sustained a fracture of the right calcaneus as the result of a motor vehicle accident 3 months ago.After 10 weeks in a cast followed by a rocker bottom immobilization boot that prevented ankle and foot motion, the fracture shows radiological evidence of bony union.The patient has been ambulating (weight bearing as tolerated) while wearing the boot and is now supposed to discontinue wearing it slowly.Your examination reveals marked limitation of dorsi- and plantarflexion and a high, rigid arch.There is no visible swelling, and pain (2/10) occurs at the end of the day and during passive range of motion (PROM) with overpressure.Which of the following is the most appropriate intervention during the first week of therapy?

• A)PROM of the ankle (dorsiflexion/plantarflexion and calcaneal inversion/eversion)
• B)Gentle passive stretching of ankle musculature
• C)Grade II joint mobilization at the subtalar joint
• D)Grade III joint mobilization at the midtarsal joint

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