A proper ligament tear will not be better by now - this can take weeks, and sometimes week or so until you can weightbear properly.
If there's no contraindication such as allergy or asthma, then ibuprofen is better for soft tissue injuries than paracetamol.
If they didn't Xray then you need to go back, in fact if you're not happy with it then go back anyway. Sometimes fractures don't show up on the first Xray. They should have given you SOS advice about returning, really.
Is he having any physio ? It may be painful but gentle flexing, such as writing letters in the air with his toes, and moving on to ankle raises while weight bearing (supported and on both feet initially, gradually buildling up to unsupported and on injured foot only) will help it heal and keep mobile. If he rests it and only uses it gingerly it could seize up and take longer to get back to normal. It could well be bruised and swollen for a few weeks.
Take him back and ask them to x-ray it. It's clinically justified if he can't weight bear, it's swollen and bruised. It sounds as if it may be broken to me, the x-ray dosage for a foot is not very high. Did he land on it when he fell or did he fall and twist it?
I've seen a few ankles, some of them looked broken and quite bad, I take the x-ray and there's nothing wrong with them, some look completely normal, I take the x-ray and they are broken. The crack sound could be the bones rubbing so doesn't necessarily mean it's broken. The nurses don't know alot about radiation protection (sorry if there are nurses here), it's a radiographers job to decide this.
Ah right. Could you take him now? It's normally busy during the day because GP's are busy little souls and send alot of patients in during the day. I don't think paracetamol will touch the pain to be honest. They are a little quieter first thing (before 10am) aswell, GP's you see.
You need to really complain about him being sent home. Did a doctor see him?
actually fluffy as a radiographer you should know that the referrer decides on whether the radn saving issue is an apppropriate reason to refer or not - i wish more drs or nurse requesters would consider this - tbh i would leave it a coupla days and see if it has improved. you dont always need an xray to decide if there is a fracture or not - some medical practitioners use diagnostic /examination skills.
The "crack" could just as easily be a grade 3 - ie complete - ligament tear, which should get orthopaedic follow-up. I doubt some Luddite half-trained numpty scared of the radiation pixies is going to have properly checked for instability - and it would have been too painful to do this at first attendance anyway. This needed an XR, crutches and follow up. And that's what he still needs. 10am is not bad for A+E, good luck!
hotbot - I would be fascinated to hear how you use "diagnostic/examination skills" to differentiate reliably between Weber A,B and C fractures, a flake fracture, or a complete ATFL tear. Because they can all have the same presentation, they're all bloody painful, and they all need different treatment.
The referrers are not always aware of the radiation protection issues, we get physio's refering people for x-ray's, if in doubt staff should ask rather then assume it's a big risk, we're not talking chest x-ray exposure here. leaving it for a couple of days could be leaving someone trying to walk on a broken bone. If it's clinicaly justified then I would x-ray.
Every x-ray has an element of risk attached to it herbietea, the question is wether the benefit outweighs this. The dose for an extremity isn't very high but the staff still have to follow the same rules and regulations as if it were a CT scan dose. There is a lack of training in some areas regarding x-rays and radiation.