How Do I Treat a Dislocated Ankle?

The ankle joint is the largest flexor plantar joint of the human body. It consists of the medial and lateral ankles and talus at the lower end of the tibia and fibula. The talus is surrounded by the ankle points composed of the medial malleolus of the tibia, the hind ankle and the lateral malleolus of the fibula. Inside the ankle. Because the talar body is in the ankle point, surrounded by strong ligaments, it is firm and stable. When ankle joints are severely injured, fractures and dislocations of the ankle joint are often combined, and simple ankle joint dislocations are also extremely rare, and often have fractures. Dislocation-based ankle injuries with minor fractures are referred to as ankle dislocations. Dislocation of the ankle joint is mostly caused by indirect violence, such as sacral or twisted injuries. It is common to fall from a high place, to land on the inside or outside of the foot, or to walk on uneven roads, or to slip on the ground, causing the foot to rotate, varus or valgus excessively, often forming dislocations, and often with fractures. According to the dislocation direction, it can be divided into: external dislocation, internal dislocation, anterior dislocation, and posterior dislocation. Generally, medial dislocation is more common, followed by lateral dislocation and open dislocation, posterior dislocation is rare, and anterior dislocation is rare.

Basic Information

English name

dislocation of ankle joint

Visiting department

orthopedics

Common locations

ankle joint

Common causes

Caused by direct or indirect violence

Common symptoms

After the injury, pain, swelling, deformity and tenderness in the ankle appear.

Causes of ankle dislocation

Mostly caused by direct or indirect violence. When the ankle is plantar flexion, the calf suddenly receives a strong forward impact, which can cause ankle dislocation. When the ankle joint is in the dorsal extension position, falling from a high place, and the heel touches the ground, it can cause an ankle dislocation. When the compressive injury separates the lower tibiofibular joint, it can cause the upper ankle dislocation.

Clinical manifestations of ankle dislocation

After the injury, pain, swelling, deformity and tenderness in the ankle appear. In the posterior dislocation, the lower end of the tibia and fibula is prominently under the skin and can be touched. The distance from the anterior edge of the tibia to the heel increases and the forefoot becomes shorter. Appearance shows that the injured limb is locally shortened, and the swelling is severe.

In the posterior dislocation, the lower end of the tibia and fibula is prominently under the skin and can be touched. The distance from the front of the tibia to the heel increases and the forefoot becomes shorter. Shortening. Routine radiographs can confirm the diagnosis. A CT scan can detect subtle fractures.

Ankle Dislocation Examination

Mainly imaging examinations, including X-rays, CT scans, etc.

Diagnosis of ankle dislocation

The diagnosis of ankle dislocation is not difficult, and conventional X-rays are easy to confirm the above diagnosis; special examination: CT scan can easily detect the presence of small fractures.

Ankle Dislocation Treatment

1. Treatment of posterior ankle dislocation

Immediate reduction should be performed under spinal or epidural anesthesia. The reduction method is to flex the knee joint first, and then perform plantar flexion and traction. When the talus enters the ankle point, the ankle joint is extended back and fixed with long leg plaster for 5 weeks. Severe fractures are treated as ankle fractures.

2. Treatment of ankle anterior dislocation

Immediately after the injury, the knee was repositioned under anesthesia. The knee joint was flexed and the dorsum of the foot was extended. When the talus and the anterior lower lip of the tibia were released, the talus was pushed downward and backward. After reduction, the leg was fixed in the plantar flexion position for 3 weeks with a long leg cast, and then the foot and ankle dorsal extension was replaced for another 2 to 3 weeks. If there is a severe fracture, the fixation time is 8-12 weeks.

3. Treatment of ankle dislocation upward

Traction reduction under good anesthesia. When resetting, the knee flexes, pulls upwards from the thighs, and pulls down by holding the feet. When the talus is down to the ankle point, the tibiofibular can be reset and engaged. At this time, the plantar flexion and extension of the ankle joint to correct anterior and posterior displacement of the ankle joint. The upper leg is cast, the foot is in the slightly dorsal position, and the inner and outer ankles should be squeezed hard to align it. The gypsum was changed at 2 weeks to avoid the relative relaxation of the gypsum after the swelling disappeared. If the soft tissue of the wound is swelled violently, and the reduction fails or is difficult to sense, open reduction can be performed. Internal fixation of the talar body is not required during surgery, but those with torn ligaments and ruptures must be repaired; those with ankle fractures must be correspondingly fixed internally after fracture reduction.