\documentclass[10pt,a4paper]{article} % Packages \usepackage{fancyhdr} % For header and footer \usepackage{multicol} % Allows multicols in tables \usepackage{tabularx} % Intelligent column widths \usepackage{tabulary} % Used in header and footer \usepackage{hhline} % Border under tables \usepackage{graphicx} % For images \usepackage{xcolor} % For hex colours %\usepackage[utf8x]{inputenc} % For unicode character support \usepackage[T1]{fontenc} % Without this we get weird character replacements \usepackage{colortbl} % For coloured tables \usepackage{setspace} % For line height \usepackage{lastpage} % Needed for total page number \usepackage{seqsplit} % Splits long words. %\usepackage{opensans} % Can't make this work so far. Shame. Would be lovely. \usepackage[normalem]{ulem} % For underlining links % Most of the following are not required for the majority % of cheat sheets but are needed for some symbol support. \usepackage{amsmath} % Symbols \usepackage{MnSymbol} % Symbols \usepackage{wasysym} % Symbols %\usepackage[english,german,french,spanish,italian]{babel} % Languages % Document Info \author{Siffi (Siffi)} \pdfinfo{ /Title (ankle-sprain.pdf) /Creator (Cheatography) /Author (Siffi (Siffi)) /Subject (Ankle Sprain Cheat Sheet) } % Lengths and widths \addtolength{\textwidth}{6cm} \addtolength{\textheight}{-1cm} \addtolength{\hoffset}{-3cm} \addtolength{\voffset}{-2cm} \setlength{\tabcolsep}{0.2cm} % Space between columns \setlength{\headsep}{-12pt} % Reduce space between header and content \setlength{\headheight}{85pt} % If less, LaTeX automatically increases it \renewcommand{\footrulewidth}{0pt} % Remove footer line \renewcommand{\headrulewidth}{0pt} % Remove header line \renewcommand{\seqinsert}{\ifmmode\allowbreak\else\-\fi} % Hyphens in seqsplit % This two commands together give roughly % the right line height in the tables \renewcommand{\arraystretch}{1.3} \onehalfspacing % Commands \newcommand{\SetRowColor}[1]{\noalign{\gdef\RowColorName{#1}}\rowcolor{\RowColorName}} % Shortcut for row colour \newcommand{\mymulticolumn}[3]{\multicolumn{#1}{>{\columncolor{\RowColorName}}#2}{#3}} % For coloured multi-cols \newcolumntype{x}[1]{>{\raggedright}p{#1}} % New column types for ragged-right paragraph columns \newcommand{\tn}{\tabularnewline} % Required as custom column type in use % Font and Colours \definecolor{HeadBackground}{HTML}{333333} \definecolor{FootBackground}{HTML}{666666} \definecolor{TextColor}{HTML}{333333} \definecolor{DarkBackground}{HTML}{7083A3} \definecolor{LightBackground}{HTML}{F6F7F9} \renewcommand{\familydefault}{\sfdefault} \color{TextColor} % Header and Footer \pagestyle{fancy} \fancyhead{} % Set header to blank \fancyfoot{} % Set footer to blank \fancyhead[L]{ \noindent \begin{multicols}{3} \begin{tabulary}{5.8cm}{C} \SetRowColor{DarkBackground} \vspace{-7pt} {\parbox{\dimexpr\textwidth-2\fboxsep\relax}{\noindent \hspace*{-6pt}\includegraphics[width=5.8cm]{/web/www.cheatography.com/public/images/cheatography_logo.pdf}} } \end{tabulary} \columnbreak \begin{tabulary}{11cm}{L} \vspace{-2pt}\large{\bf{\textcolor{DarkBackground}{\textrm{Ankle Sprain Cheat Sheet}}}} \\ \normalsize{by \textcolor{DarkBackground}{Siffi (Siffi)} via \textcolor{DarkBackground}{\uline{cheatography.com/122609/cs/26253/}}} \end{tabulary} \end{multicols}} \fancyfoot[L]{ \footnotesize \noindent \begin{multicols}{3} \begin{tabulary}{5.8cm}{LL} \SetRowColor{FootBackground} \mymulticolumn{2}{p{5.377cm}}{\bf\textcolor{white}{Cheatographer}} \\ \vspace{-2pt}Siffi (Siffi) \\ \uline{cheatography.com/siffi} \\ \end{tabulary} \vfill \columnbreak \begin{tabulary}{5.8cm}{L} \SetRowColor{FootBackground} \mymulticolumn{1}{p{5.377cm}}{\bf\textcolor{white}{Cheat Sheet}} \\ \vspace{-2pt}Published 3rd November, 2021.\\ Updated 3rd November, 2021.\\ Page {\thepage} of \pageref{LastPage}. \end{tabulary} \vfill \columnbreak \begin{tabulary}{5.8cm}{L} \SetRowColor{FootBackground} \mymulticolumn{1}{p{5.377cm}}{\bf\textcolor{white}{Sponsor}} \\ \SetRowColor{white} \vspace{-5pt} %\includegraphics[width=48px,height=48px]{dave.jpeg} Measure your website readability!\\ www.readability-score.com \end{tabulary} \end{multicols}} \begin{document} \raggedright \raggedcolumns % Set font size to small. Switch to any value % from this page to resize cheat sheet text: % www.emerson.emory.edu/services/latex/latex_169.html \footnotesize % Small font. \begin{tabularx}{17.67cm}{X} \SetRowColor{DarkBackground} \mymulticolumn{1}{x{17.67cm}}{\bf\textcolor{white}{Ankle anatomy}} \tn \SetRowColor{LightBackground} \mymulticolumn{1}{p{17.67cm}}{\vspace{1px}\centerline{\includegraphics[width=5.1cm]{/web/www.cheatography.com/public/uploads/siffi_1611318334_download.jpg}}} \tn \hhline{>{\arrayrulecolor{DarkBackground}}-} \SetRowColor{LightBackground} \mymulticolumn{1}{x{17.67cm}}{Deltoid ligament limits eversion, dorsiflexion and plantarflexion - rarely injured (strongest ligament), isolated sprains are {\bf{rare}} \newline Most commonly sprained = Anterior talofibular ligament {\bf{(ATFL)}} - due to it being the weakest ligament \newline and Calcaneofibular ligament {\bf{(CFL)}}} \tn \hhline{>{\arrayrulecolor{DarkBackground}}-} \end{tabularx} \par\addvspace{1.3em} \begin{tabularx}{17.67cm}{p{1.727 cm} p{1.727 cm} } \SetRowColor{DarkBackground} \mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Complications}} \tn % Row 0 \SetRowColor{LightBackground} \mymulticolumn{2}{x{17.67cm}}{- Chronic pain/disability} \tn % Row Count 1 (+ 1) % Row 1 \SetRowColor{white} \mymulticolumn{2}{x{17.67cm}}{- Recurrent Ankle instability} \tn % Row Count 2 (+ 1) % Row 2 \SetRowColor{LightBackground} \mymulticolumn{2}{x{17.67cm}}{- Osteochrondral defects of the talus} \tn % Row Count 3 (+ 1) % Row 3 \SetRowColor{white} \mymulticolumn{2}{x{17.67cm}}{- Peroneal tendon injuries} \tn % Row Count 4 (+ 1) % Row 4 \SetRowColor{LightBackground} \mymulticolumn{2}{x{17.67cm}}{- Neurovascular injuries} \tn % Row Count 5 (+ 1) % Row 5 \SetRowColor{white} \mymulticolumn{2}{x{17.67cm}}{- Tibiotalar OA} \tn % Row Count 6 (+ 1) % Row 6 \SetRowColor{LightBackground} \mymulticolumn{2}{x{17.67cm}}{- Pantalar OA} \tn % Row Count 7 (+ 1) \hhline{>{\arrayrulecolor{DarkBackground}}--} \end{tabularx} \par\addvspace{1.3em} \begin{tabularx}{17.67cm}{p{1.727 cm} p{1.727 cm} } \SetRowColor{DarkBackground} \mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Classification}} \tn % Row 0 \SetRowColor{LightBackground} \mymulticolumn{2}{x{17.67cm}}{- Grade I: Stretch with no macroscopic fibre disruption} \tn % Row Count 2 (+ 2) % Row 1 \SetRowColor{white} \mymulticolumn{2}{x{17.67cm}}{- Grade II: Partial Fibre disruption} \tn % Row Count 3 (+ 1) % Row 2 \SetRowColor{LightBackground} \mymulticolumn{2}{x{17.67cm}}{- Grade III: Rupture (Usually associated with another injury, usually f\#) + syndesmotic structures + tendon rupture} \tn % Row Count 6 (+ 3) \hhline{>{\arrayrulecolor{DarkBackground}}--} \end{tabularx} \par\addvspace{1.3em} \begin{tabularx}{17.67cm}{p{1.727 cm} p{1.727 cm} } \SetRowColor{DarkBackground} \mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Demographics/Causes}} \tn % Row 0 \SetRowColor{LightBackground} \mymulticolumn{2}{x{17.67cm}}{- Physically active people (basketball, football,soccer, soldiers)- most common} \tn % Row Count 2 (+ 2) % Row 1 \SetRowColor{white} \mymulticolumn{2}{x{17.67cm}}{- Males and females affected equally} \tn % Row Count 3 (+ 1) % Row 2 \SetRowColor{LightBackground} \mymulticolumn{2}{x{17.67cm}}{- Highest in 15-19 yo} \tn % Row Count 4 (+ 1) % Row 3 \SetRowColor{white} \mymulticolumn{2}{x{17.67cm}}{- Limited ankle dorsiflexion} \tn % Row Count 5 (+ 1) % Row 4 \SetRowColor{LightBackground} \mymulticolumn{2}{x{17.67cm}}{- Previous Hx of ankle sprain} \tn % Row Count 6 (+ 1) % Row 5 \SetRowColor{white} \mymulticolumn{2}{x{17.67cm}}{- Lateral ankle = inversion sprain} \tn % Row Count 7 (+ 1) % Row 6 \SetRowColor{LightBackground} \mymulticolumn{2}{x{17.67cm}}{- Medial ankle = eversion sprain (rare due to limited eversion of the ankle) \{\{nl\}\} Usually occurs due to eversion/pronation and abduction/external rotation \{\{nl\}\} Foot planted in pronation, upper body falls laterally -unexpected misstep/landing on uneven surface} \tn % Row Count 13 (+ 6) \hhline{>{\arrayrulecolor{DarkBackground}}--} \end{tabularx} \par\addvspace{1.3em} \begin{tabularx}{17.67cm}{p{1.727 cm} p{1.727 cm} } \SetRowColor{DarkBackground} \mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Presentation}} \tn % Row 0 \SetRowColor{LightBackground} \mymulticolumn{2}{x{17.67cm}}{- Sudden onset of pain from "rolling the ankle"/landing from a jump/stepping into a hole} \tn % Row Count 2 (+ 2) % Row 1 \SetRowColor{white} \mymulticolumn{2}{x{17.67cm}}{- Pts may recall a pop at the time} \tn % Row Count 3 (+ 1) % Row 2 \SetRowColor{LightBackground} \mymulticolumn{2}{x{17.67cm}}{- Pain from mild aching to intense (worse at the end of the day} \tn % Row Count 5 (+ 2) % Row 3 \SetRowColor{white} \mymulticolumn{2}{x{17.67cm}}{- Aggravated by weight bearing} \tn % Row Count 6 (+ 1) % Row 4 \SetRowColor{LightBackground} \mymulticolumn{2}{x{17.67cm}}{- Swelling (worse at the end of the day)} \tn % Row Count 7 (+ 1) % Row 5 \SetRowColor{white} \mymulticolumn{2}{x{17.67cm}}{- Rapid bruising and swelling could indicate rupture} \tn % Row Count 9 (+ 2) % Row 6 \SetRowColor{LightBackground} \mymulticolumn{2}{x{17.67cm}}{- Bruising and discolouration gradually gravitates towards foot} \tn % Row Count 11 (+ 2) % Row 7 \SetRowColor{white} \mymulticolumn{2}{x{17.67cm}}{- Cold foot and or paraesthesia = neurovascular compromise/compartment syndrome} \tn % Row Count 13 (+ 2) % Row 8 \SetRowColor{LightBackground} \mymulticolumn{2}{x{17.67cm}}{- Tenderness over affected ligament} \tn % Row Count 14 (+ 1) % Row 9 \SetRowColor{white} \mymulticolumn{2}{x{17.67cm}}{- ROM may be painful on passive inversion/dorsiflexion (lateral) or passive eversion (medial)} \tn % Row Count 16 (+ 2) % Row 10 \SetRowColor{LightBackground} \mymulticolumn{2}{x{17.67cm}}{- +ve Talar tilt, +ve Anterior draw test, +ve ankle eversion stress test +ve external rot test} \tn % Row Count 18 (+ 2) % Row 11 \SetRowColor{white} \mymulticolumn{2}{x{17.67cm}}{- Syndesmotic sprains can be differentiated with the fibular squeeze test (rare in the general population, ankle in high forced ext rot and/ankle dorsiflexion)} \tn % Row Count 22 (+ 4) % Row 12 \SetRowColor{LightBackground} \mymulticolumn{2}{x{17.67cm}}{- Palpation dorsalis pedis and posterior tibia pulses + sensation over foot for neurovascular compromise} \tn % Row Count 25 (+ 3) % Row 13 \SetRowColor{white} \mymulticolumn{2}{x{17.67cm}}{- Suspect instability = recurrent sprains, difficulty running on uneven surfaces, cutting and jumping, giving way} \tn % Row Count 28 (+ 3) % Row 14 \SetRowColor{LightBackground} \mymulticolumn{2}{x{17.67cm}}{- Palpation of ATFL, CFL and PTFL and medial ankle and entire fibula to assess for f\# (pain and crepitus)} \tn % Row Count 31 (+ 3) \end{tabularx} \par\addvspace{1.3em} \begin{tabularx}{17.67cm}{p{1.727 cm} p{1.727 cm} } \SetRowColor{DarkBackground} \mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Presentation (cont)}} \tn % Row 15 \SetRowColor{LightBackground} \mymulticolumn{2}{x{17.67cm}}{- Assess foot : especially navicular, midfoot and 5th metatarsal} \tn % Row Count 2 (+ 2) \hhline{>{\arrayrulecolor{DarkBackground}}--} \SetRowColor{LightBackground} \mymulticolumn{2}{x{17.67cm}}{- FADI, FAAM, LEFS and sports ankle rating system} \tn \hhline{>{\arrayrulecolor{DarkBackground}}--} \end{tabularx} \par\addvspace{1.3em} \begin{tabularx}{17.67cm}{p{1.727 cm} p{1.727 cm} } \SetRowColor{DarkBackground} \mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Red Flags}} \tn % Row 0 \SetRowColor{LightBackground} \mymulticolumn{2}{x{17.67cm}}{- Significant Instability} \tn % Row Count 1 (+ 1) % Row 1 \SetRowColor{white} \mymulticolumn{2}{x{17.67cm}}{- Significant Crepitus} \tn % Row Count 2 (+ 1) % Row 2 \SetRowColor{LightBackground} \mymulticolumn{2}{x{17.67cm}}{- Catching} \tn % Row Count 3 (+ 1) % Row 3 \SetRowColor{white} \mymulticolumn{2}{x{17.67cm}}{- No response to conservative care after 4-6 weeks} \tn % Row Count 4 (+ 1) % Row 4 \SetRowColor{LightBackground} \mymulticolumn{2}{x{17.67cm}}{- MRI/US considered} \tn % Row Count 5 (+ 1) \hhline{>{\arrayrulecolor{DarkBackground}}--} \end{tabularx} \par\addvspace{1.3em} \begin{tabularx}{17.67cm}{X} \SetRowColor{DarkBackground} \mymulticolumn{1}{x{17.67cm}}{\bf\textcolor{white}{Imaging}} \tn \SetRowColor{LightBackground} \mymulticolumn{1}{p{17.67cm}}{\vspace{1px}\centerline{\includegraphics[width=5.1cm]{/web/www.cheatography.com/public/uploads/siffi_1611319673_ottoasdf.png}}} \tn \hhline{>{\arrayrulecolor{DarkBackground}}-} \SetRowColor{LightBackground} \mymulticolumn{1}{x{17.67cm}}{- {\bf{Ottawa Ankle rules:}} \newline - {\bf{Ankle X-ray}} = bone tenderness at A \newline - Bone Tenderness at B \newline - Inability to weight bear both immediately and on physical exam \newline - AP, Lat, Mortise views \newline \newline - {\bf{Foot X-ray}} = Bony tenderness at C and D \newline - Inability to weight bear both immediately and on physical exam \newline - AP, lateral, oblique \newline \newline - Moderate spec, high sens \newline - Should {\bf{not}} be used: \newline - A distracting injury \newline - Intoxication \newline - Diminished lower extremity sensation \newline - Head injury/cooperation disorders} \tn \hhline{>{\arrayrulecolor{DarkBackground}}-} \end{tabularx} \par\addvspace{1.3em} \begin{tabularx}{17.67cm}{p{1.727 cm} p{1.727 cm} } \SetRowColor{DarkBackground} \mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{DDx}} \tn % Row 0 \SetRowColor{LightBackground} \mymulticolumn{2}{x{17.67cm}}{- Syndesmotic sprain} \tn % Row Count 1 (+ 1) % Row 1 \SetRowColor{white} \mymulticolumn{2}{x{17.67cm}}{- F\# (Lisfranc)} \tn % Row Count 2 (+ 1) % Row 2 \SetRowColor{LightBackground} \mymulticolumn{2}{x{17.67cm}}{- Dislocation} \tn % Row Count 3 (+ 1) % Row 3 \SetRowColor{white} \mymulticolumn{2}{x{17.67cm}}{- Intraaritcular meniscoid} \tn % Row Count 4 (+ 1) % Row 4 \SetRowColor{LightBackground} \mymulticolumn{2}{x{17.67cm}}{- Subtalar sprain} \tn % Row Count 5 (+ 1) % Row 5 \SetRowColor{white} \mymulticolumn{2}{x{17.67cm}}{- Achilles tendinopathy} \tn % Row Count 6 (+ 1) % Row 6 \SetRowColor{LightBackground} \mymulticolumn{2}{x{17.67cm}}{- CRPS} \tn % Row Count 7 (+ 1) % Row 7 \SetRowColor{white} \mymulticolumn{2}{x{17.67cm}}{- Inflammatory Arthropathy} \tn % Row Count 8 (+ 1) \hhline{>{\arrayrulecolor{DarkBackground}}--} \end{tabularx} \par\addvspace{1.3em} \begin{tabularx}{17.67cm}{p{1.727 cm} p{1.727 cm} } \SetRowColor{DarkBackground} \mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Management}} \tn % Row 0 \SetRowColor{LightBackground} \mymulticolumn{2}{x{17.67cm}}{- Usually heal quickly, but some report pain, instability, crepitus, weakness, stiffness, swelling} \tn % Row Count 2 (+ 2) % Row 1 \SetRowColor{white} \mymulticolumn{2}{x{17.67cm}}{- PRICE for 72 hours after injury} \tn % Row Count 3 (+ 1) % Row 2 \SetRowColor{LightBackground} \mymulticolumn{2}{x{17.67cm}}{- Ice/ice massage for 15 minutes each hour} \tn % Row Count 4 (+ 1) % Row 3 \SetRowColor{white} \mymulticolumn{2}{x{17.67cm}}{- NSAID advice} \tn % Row Count 5 (+ 1) % Row 4 \SetRowColor{LightBackground} \mymulticolumn{2}{x{17.67cm}}{- All sprains may require complete immobilisation} \tn % Row Count 6 (+ 1) % Row 5 \SetRowColor{white} \mymulticolumn{2}{x{17.67cm}}{- Prevention = taping/using devices (air splint/velcro brace)} \tn % Row Count 8 (+ 2) % Row 6 \SetRowColor{LightBackground} \mymulticolumn{2}{x{17.67cm}}{- Then manual therapy} \tn % Row Count 9 (+ 1) % Row 7 \SetRowColor{white} \mymulticolumn{2}{x{17.67cm}}{- Joint mobilisation} \tn % Row Count 10 (+ 1) % Row 8 \SetRowColor{LightBackground} \mymulticolumn{2}{x{17.67cm}}{- Transverse friction massage of affected ligament} \tn % Row Count 11 (+ 1) % Row 9 \SetRowColor{white} \mymulticolumn{2}{x{17.67cm}}{- Myofascial release and stretching of gastrosoleus} \tn % Row Count 13 (+ 2) % Row 10 \SetRowColor{LightBackground} \mymulticolumn{2}{x{17.67cm}}{- Ankle Alphabet} \tn % Row Count 14 (+ 1) % Row 11 \SetRowColor{white} \mymulticolumn{2}{x{17.67cm}}{- When ROM, pain and swelling improves, move onto strengthening} \tn % Row Count 16 (+ 2) % Row 12 \SetRowColor{LightBackground} \mymulticolumn{2}{x{17.67cm}}{- Strengthening includes isometric contractions against immobile object then to dynamic resistance with weights, tubing, bands} \tn % Row Count 19 (+ 3) % Row 13 \SetRowColor{white} \mymulticolumn{2}{x{17.67cm}}{- Strenghtening of dorsiflexion, plantar flexion, inversion and eversion} \tn % Row Count 21 (+ 2) % Row 14 \SetRowColor{LightBackground} \mymulticolumn{2}{x{17.67cm}}{- Strengthening of Peroneals (resisted eversion)} \tn % Row Count 22 (+ 1) % Row 15 \SetRowColor{white} \mymulticolumn{2}{x{17.67cm}}{- If ankle is instable = hip abductor strengthening} \tn % Row Count 24 (+ 2) % Row 16 \SetRowColor{LightBackground} \mymulticolumn{2}{x{17.67cm}}{-Wobbleboard to gain proprioception} \tn % Row Count 25 (+ 1) % Row 17 \SetRowColor{white} \mymulticolumn{2}{x{17.67cm}}{- Return to activity starts with straight line then progress to forwards/backwards, side to side,pivoting cutting motions} \tn % Row Count 28 (+ 3) % Row 18 \SetRowColor{LightBackground} \mymulticolumn{2}{x{17.67cm}}{- Return to play = full pain free ROM and ankle strength \textgreater{}80-90\%} \tn % Row Count 30 (+ 2) \end{tabularx} \par\addvspace{1.3em} \begin{tabularx}{17.67cm}{p{1.727 cm} p{1.727 cm} } \SetRowColor{DarkBackground} \mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Management (cont)}} \tn % Row 19 \SetRowColor{LightBackground} \mymulticolumn{2}{x{17.67cm}}{- Grade III/ syndesmosis involvement = surgical consult (younger patients with occupation/activities that places them at higher risk of re-injury)} \tn % Row Count 3 (+ 3) % Row 20 \SetRowColor{white} \mymulticolumn{2}{x{17.67cm}}{- If ligamentous laxity - immobilise and crutches should be given, refer to orthopaedic surgeon (could be osteochondral defects of the talus, peroneal tendon, intra-articular loose bodies and fractures)} \tn % Row Count 8 (+ 5) \hhline{>{\arrayrulecolor{DarkBackground}}--} \end{tabularx} \par\addvspace{1.3em} \begin{tabularx}{17.67cm}{p{1.727 cm} p{1.727 cm} } \SetRowColor{DarkBackground} \mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Whitman's CPR}} \tn % Row 0 \SetRowColor{LightBackground} \mymulticolumn{2}{x{17.67cm}}{- Symptom's worse when standing} \tn % Row Count 1 (+ 1) % Row 1 \SetRowColor{white} \mymulticolumn{2}{x{17.67cm}}{- Symptoms worse in the evening} \tn % Row Count 2 (+ 1) % Row 2 \SetRowColor{LightBackground} \mymulticolumn{2}{x{17.67cm}}{- Navicular drop \textgreater{}5mm} \tn % Row Count 3 (+ 1) % Row 3 \SetRowColor{white} \mymulticolumn{2}{x{17.67cm}}{- Distal tibiofibular joint hypomobility} \tn % Row Count 4 (+ 1) \hhline{>{\arrayrulecolor{DarkBackground}}--} \SetRowColor{LightBackground} \mymulticolumn{2}{x{17.67cm}}{- Predicts the sucess of manipulation and exercise \newline - 3 out of the 4 variables above = \textgreater{}95\% sucess rate} \tn \hhline{>{\arrayrulecolor{DarkBackground}}--} \end{tabularx} \par\addvspace{1.3em} \begin{tabularx}{17.67cm}{p{1.727 cm} p{1.727 cm} } \SetRowColor{DarkBackground} \mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Prognosis}} \tn % Row 0 \SetRowColor{LightBackground} \mymulticolumn{2}{x{17.67cm}}{- Mild- Moderate sprains usually recover within 7-15 days} \tn % Row Count 2 (+ 2) % Row 1 \SetRowColor{white} \mymulticolumn{2}{x{17.67cm}}{- Instability and defects occur in 25-40\% of patients} \tn % Row Count 4 (+ 2) \hhline{>{\arrayrulecolor{DarkBackground}}--} \end{tabularx} \par\addvspace{1.3em} \end{document}