Presentation
#: VPT1-00987-EN Version: A Duration: 00:05:56 Publication Date: 2/27/18 Audio available Available in High Definition Presenter: Norman E. [arthrex.com]
Information presented as part of this activity is intended solely as continuing medical education and is not intended to promote off-label use of any pharmaceutical product. [ebmedicine.net]
POSTERIOR DISLOCATION ( FIGURE 67.1 ) Usually result of forced plantar flexion or a strong forward force applied to the posterior tibia Most are associated with a fracture of one or more malleoli Presents with the ankle held in plantar flexion with foot [aneskey.com]
In majority of reported case it presents as an open injury making the closed injury more rare presentation. The stability of the ankle joint depends on medial and lateral ligaments. [ncbi.nlm.nih.gov]
A case report is presented below to help accurately diagnose and treat the Bosworth ankle fracture-dislocation. [www2.aoao.org]
Entire Body System
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Hunting
Reprinted with permission from Hunt KJ, Phisitkul P, Pirolo J, Amendola A. High ankle sprains and syndesmotic injuries in athletes. J Am Acad Orthop Surg. 2015;23(11):661-673. [journals.sagepub.com]
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Wound Infection
Antibiotics were administered both pre- and postoperatively to prevent wound infection. Antibiotic treatment is essential since it has been reported that the rate of wound infection in patients with ankle fractures can reach up to 10% [ 20, 21 ]. [bmcsurg.biomedcentral.com]
Cardiovascular
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Hypertension
The Foot & Ankle Journal ( www.faoj.org ) Accepted: November, 2008 Published: December, 2008 ISSN 1941-6806 doi: 10.3827/faoj.2008.0112.0001 Case Report A 41-year-old male with past medical history of hypertension presented to the emergency department [faoj.org]
Musculoskeletal
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Muscle Weakness
Possible risk factors that may predispose a patient to dislocation include the following: joint hyperlaxity, internal malleolar hypoplasia, peroneal muscle weakness, and a history of prior ankle sprains. [boneandspine.com]
Moehring et al. [ 5 ] suggested that some factors such as medial malleolus hypoplasia, ligamentous laxity and peroneal muscles weakness can predispose ankle to pure dislocation. [ncbi.nlm.nih.gov]
Skin
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Insect Bite
) frostbite ( T33-T34 ) insect bite or sting, venomous ( T63.4 ) Injuries to the ankle and foot S93 ICD-10-CM Diagnosis Code S93 Dislocation and sprain of joints and ligaments at ankle, foot and toe level 2016 2017 2018 2019 2020 Non-Billable/Non-Specific [icd10data.com]
Neurologic
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Neglect
Neglected ankle dislocation. J Foot Ankle Surg. 2007;46:307-9. [ijoro.org]
Neglected ankle dislocation. J Foot Ankle Surg. 2007 ; 46: 307 – 9. 10.3402/dfa.v3i0.18411. [Taylor & Francis Online], [Google Scholar]. [tandfonline.com]
Treatment
Operative treatment of ankle fracture-dislocations. A follow-up study of 306/321 consecutive cases. Posteromedial dislocation of the ankle without fracture. [wheelessonline.com]
Patients receive treatment at Yale-New Haven Hospital--a nationally recognized Level I Trauma Center. [yalemedicine.org]
Bohler L. the treatment of Fractures, English ed. 4, William Wood Publishers, Baltimore; 1936: 453. Giordana CP, Koval KJ. Treatment of fracture blisters: a prospective study of 53 cases. Orthop Trauma. 1995;9:171-6. Saied A, Ziayie A. [ijoro.org]
Preferred Name Open treatment of ankle dislocation, with or without percutaneous skeletal fixation; without repair or internal fixation Synonyms Open reduction of dislocation of ankle ID altLabel Open reduction of dislocation of ankle Open reduction of [bioportal.bioontology.org]
While these treatment methods have been documented through a written format, a formal treatment algorithm has yet to be developed. [livingstonpodiatry.com]
Prognosis
Prognosis of an Dislocated Ankle The prognosis of an ankle dislocation depends on the amount of damage to the ankle. If there is any joint cartilage damage, it predisposes the ankle to development of arthritis. [footankleinstitute.com]
To date, there has been no precedent for accurate descriptions of the mechanisms, optimum treatment, and long-term prognosis of this injury. Our goal was to evaluate these variables by a retrospective review of cases from our institution. [ncbi.nlm.nih.gov]
[…] capsular structures is often severe, and the risk of infection secondary to open injury is often significant; however, prompt reduction and, when warranted, operative debridement and repair usually lead to excellent functional recovery and long-term prognosis [emedicine.medscape.com]
Prognosis Most people recover full function following a course of conservative care of physical therapy to strengthen and stabilize the ankle following the immobilization period. [twinboro.com]
However, early reduction, young age, and the absence of vascular and neuronal injury were associated with a better overall prognosis in our case. [onlinelibrary.wiley.com]
Etiology
A initial encounter, D subsequent encounter, S sequela Ankle Dislocation ICD-9 837.0(closed), 837.1(open) Ankle Dislocation Etiology / Epidemiology / Natural History Ankle Dislocation Anatomy Ankle Dislocation Clinical Evaluation Ankle Dislocation Xray [eorif.com]
Background & Etiology (Cause) The ankle is made of two joints. These joints need to be strong because they support the weight of the entire body. The ankle is one of the most versatile joint complexes in the body. [twinboro.com]
Epidemiology
A initial encounter, D subsequent encounter, S sequela Ankle Dislocation ICD-9 837.0(closed), 837.1(open) Ankle Dislocation Etiology / Epidemiology / Natural History Ankle Dislocation Anatomy Ankle Dislocation Clinical Evaluation Ankle Dislocation Xray [eorif.com]
Epidemiology Associated fractures are the rule rather than the exception with ankle dislocations. Ligamentous disruption varies according to the type of dislocation. (See Ankle Injury, Soft Tissue .) [emedicine.medscape.com]
Garrick JG (1977) The frequency of injury, mechanism of injury, and epidemiology of ankle sprains. Am JSports Med 5:241-242. Kelly PJ, Peterson LF (1962) Compound dislocation of the ankle without fracture. Am JSurg103:170-172. [omicsonline.org]
The frequency of injury, mechanism of injury, and epidemiology of ankle sprains. Am J Sports Med. 1977 ; 5: 241 – 2. 10.3402/dfa.v3i0.18411. [tandfonline.com]
The frequency of injury, mechanism of injury, and epidemiology of ankle sprains. Am J Sports Med 1977 ; 5 : 241 –2. Elise S, Maynou C, Mestdagh H, et al. Les luxations tibio-astragaliennes pures a propos de 16 observations. [bjsm.bmj.com]
Pathophysiology
Dislocation of Ankle Relevant Anatomy of Ankle Joint and Pathophysiology The ankle joint is formed by distal part of the tibia including medial malleolus and the distal part of the fibula called lateral malleolus which articulates with talus bone. [boneandspine.com]
An external fixator was used to stabilize the limb. [5] Pathophysiology The ankle joint is designed for a balance of stability and flexibility, particularly the former. [emedicine.medscape.com]
Prevention
Is it possible to prevent a dislocated ankle? A dislocated ankle is an accidental injury and most often cannot be prevented. [medicinenet.com]
Crutches help you keep your weight off your ankle, and help prevent more ankle damage. Physical therapy: A physical therapist teaches you exercises to help improve movement and strength, and to decrease pain. [drugs.com]
A medical team’s first responsibility is to reduce the dislocation to prevent further damage to the soft tissues and to realign the bones. The ankle will be splinted and immobilized to prevent further injury. [liveactivesportmed.com]
The American Academy of Orthopedic Surgeons lists several tips on preventing stress fractures. Make sure you gradually work into activities. Do not try to accomplish your ultimate goal in the first week of beginning a training program. [kcbj.com]
Is It Possible to Prevent a Dislocated Ankle? Ankle dislocations occur due to traumatic injuries due to falls, accidents, or sports-related injuries and usually are not preventable. [emedicinehealth.com]