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Ankle Dislocation


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]
  • A case report is presented below to help accurately diagnose and treat the Bosworth ankle fracture-dislocation.[www2.aoao.org]
  • 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]
Soft Tissue Swelling
  • Associated soft tissue swelling. Case Discussion This is a severe injury that required internal fixation. 2 public playlist includes this case Related Radiopaedia articles Ankle fractures Promoted articles (advertising)[radiopaedia.org]
  • tissue swelling, compartment syndrome, skin necrosis, and unsuccessful attempts at close reduction.[www2.aoao.org]
  • Surgery was performed once the soft-tissue swelling had been alleviated, provided no contraindication to surgery. Antibiotics were administered both pre- and postoperatively to prevent wound infection.[bmcsurg.biomedcentral.com]
Gangrene
  • Vascular compromise may result in avascular necrosis of the talus, tissue necrosis or even gangrene. The neural injury may result in a neural deficit, mainly sensory.[boneandspine.com]
  • Vascular compromise may result in avascular compromise of the talus, permanent sensation or nerve damage, and lower extremity tissue necrosis; and gangrene may occur if not promptly reduced.[emedicine.medscape.com]
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]
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]
Camping
  • Today, we successfully completed "Boot Camp' running, hopping and jumping! We appreciate all that you have done. We will truly miss you all, but you have taught us well. We are forever grateful." Denise M.[twinboro.com]
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]
Blister
  • Treatment of fracture blisters: a prospective study of 53 cases. Orthop Trauma. 1995;9:171-6. Saied A, Ziayie A. Neglected ankle dislocation. J Foot Ankle Surg. 2007;46:307-9.[ijoro.org]
  • […] under the cast or splint The toes on the foot of your injured leg are cold, blue, numb, or tingly The injury doesn’t seem to be healing You can't move your toes on the foot of your injured leg The skin is discolored (looks blue, purple, or gray), has blisters[fairview.org]
  • […] under the cast or splint The toes on the foot of your injured leg are cold, blue, numb, or tingly The injury doesn’t seem to be healing You can’t move your toes on the foot of your injured leg The skin is discolored (looks blue, purple, or gray), has blisters[doctorstelemedicine.com]
  • There was moderate left ankle swelling with associated medial ecchymosis and a 2 cm medial fracture blister. Pulses were weakly palpable, but the foot was warm and the capillary refill was brisk. Gross motor was intact.[www2.aoao.org]
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]
Osteophyte
  • Radiographic abnormalities consisted of minor ligamentous or capsular calcification in all patients, small osteophytes in four patients, and minimal joint space narrowing in one patient. No patient had normal radiographs.[ncbi.nlm.nih.gov]
  • However, his last radiographic image showed tiny osteophyte at talar neck ( Figure 7 ). Functional outcome assessment was performed by using AOFAS Ankle-Hindfoot score and foot and ankle VAS questionnaire.[omicsonline.org]
  • Post-traumatic arthritis was considered to be achieved if there exists narrowing joint space, subchondral bone sclerosis, osteophyte formation and bone cystic degeneration [ 23 ].[bmcsurg.biomedcentral.com]
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]
Suggestibility
  • Palomo-Traver, et al., [3] also suggested the deformity be reduced with the exception of gross contamination or complete extrusion, as he suggested the risk of infection and AVN correlates with the degree of extrusion of the bone.[faoj.org]
  • Physicians suggest an ambulance be called to transport someone with a dislocated ankle to a hospital’s emergency room.[isk-institute.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]
  • Conclusions The findings suggest that the intraoperative ankle dislocation approach appears to be a promising surgical option for unstable trimalleolar fractures involving posterior ankle comminuted fracture because it can provide better functional outcomes[bmcsurg.biomedcentral.com]
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]

Workup

Joint Space Narrowing
  • Radiographic abnormalities consisted of minor ligamentous or capsular calcification in all patients, small osteophytes in four patients, and minimal joint space narrowing in one patient. No patient had normal radiographs.[ncbi.nlm.nih.gov]

Treatment

  • Patients receive treatment at Yale-New Haven Hospital--a nationally recognized Level I Trauma Center.[yalemedicine.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]
  • Operative treatment of ankle fracture-dislocations. A follow-up study of 306/321 consecutive cases. Posteromedial dislocation of the ankle without fracture.[wheelessonline.com]
  • While these treatment methods have been documented through a written format, a formal treatment algorithm has yet to be developed.[livingstonpodiatry.com]
  • The success rate of treatment is largely dictated by patient compliance.[physioadvisor.com.au]

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]
Sex distribution
Age distribution

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]

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