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Dislocated Ankle

Ankle dislocations without fractures are very rare. This serious injury happens when bones in the ankle joint separate unnaturally. Although people of any age can experience this injury, men face a higher risk of ankle joint dislocation.

Sports accidents and car crashes lead the list of causes. The posterior dislocation, where the talus bone shifts backwards from the tibia, remains the most common type. Research shows that most dislocations move in the posteromedial direction.

A dislocated ankle usually shows clear joint deformity and causes severe pain. The condition can be serious if the patient experiences wounds and broken bones in the tibia, fibula, or talus. 

This article covers everything about ankle dislocations, from symptoms to recovery expectations. The information helps patients and learners understand the condition better and make smart choices about treatment options. 

What is a Dislocated Ankle?

The ankle joint consists of three significant bones: tibia, fibula, and talus. Strong ligaments typically hold these bones together firmly. The talus bone moves out of its normal arrangement with the tibia and fibula in a dislocated ankle, which damages the surrounding tissues. This serious condition usually happens with fractures because ankle ligaments are stronger than bones. Dislocations without fractures rarely occur and represent only a small percentage of all ankle injuries.

Symptoms and Signs of a Dislocated Ankle

The following are some common ankle dislocation symptoms:

  • Sharp, severe pain that makes walking impossible
  • Clear deformity and swelling
  • Bruising around the joint area
  • Limited ankle movement
  • Pain when touched
  • Numbness or tingling sensations if nerves get affected

Causes of a Dislocated Ankle

High-energy impacts cause most dislocations. Sports accidents lead the list, followed by car crashes or other traumatic incidents. Additionally, it can happen from bad falls or when the ankle rolls too far during activities.

Risk Factors

These factors raise the chance of dislocation:

  • Past ankle injuries
  • Playing sports
  • Birth defects in the ankle
  • Conditions that loosen ligaments like Ehlers-Danlos syndrome
  • Being overweight and smoking

Complications of a Dislocated Ankle

Without the right treatment patients might develop:

  • Joint stiffness
  • Ongoing pain
  • Post-traumatic arthritis
  • Infections
  • Bones that don't heal properly
  • Nerve damage
  • Blood vessel injuries
  • Compartment syndrome (in rare cases)

Diagnosis

Physical assessment: A doctor starts by asking how you got hurt and looks at your ankle's appearance. The physical exam shows if bones sit wrong and reveals other possible injuries. Healthcare teams also check:

  • Your foot's blood flow and nerve function
  • The skin around prominent bones
  • How well you can move and stabilise the joint
  • X-ray of the ankle: X-rays from different angles (anteroposterior, lateral, and mortise views) confirm what's wrong. New X-rays after treatment show if everything lines up right. 
  • Doctors might need CT scans or MRIs to assess ligament damage or hidden fractures.

Treatments

The main goal is getting bones back where they belong as fast as possible. Ankle dislocation treatment options are:

  • RICE method (Rest, Ice, Compression, Elevation) to reduce swelling
  • Medicine for pain and sedation during procedures
  • Careful hands-on work to fix the joint
  • A splint, cast, or brace you will wear for about six weeks
  • Support from crutches or other walking aids
  • Surgery if simple fixes don't work or problems come up

After the cast comes off, physical therapy helps bring back your strength and movement. 

When to See a Doctor

You need emergency care right away if you think your ankle is dislocated. Don't try fixing the joint yourself - you could make things much worse. Get urgent help if:

  • Your ankle looks deformed
  • Really bad pain or swelling
  • You can't move the joint
  • Parts of your foot feel numb or tingly

Conclusion

Ankle dislocations are definitely among the most painful joint injuries you can experience. These injuries occur less frequently than other ankle problems, but they just need immediate medical attention. 

Physical therapy plays a significant role in building back strength and movement. Most patients worry about lasting effects, but proper medical care and patience during healing help them return to their regular activities. Ankle dislocations may seem scary, but today's medical treatments and dedicated rehabilitation lead to successful healing.

FAQs

1. Why is a dislocated ankle so bad?

A dislocated ankle affects multiple structures at once. The force tears strong ligaments, damages blood vessels, and can harm nerves. It also comes with fractures in all but one of these cases. The sheer force needed to dislodge this naturally stable joint out of place leaves lasting effects beyond the original injury.

2. Can I walk with a dislocated ankle?

The pain and deformity make it impossible to walk. Patients feel intense pain right away that stops them from putting any weight on it. The obvious misalignment and major swelling make movement even harder.

3. How long is the recovery for a dislocated ankle?

Most people need 6-12 weeks to get back to their normal activities. But surgical cases take longer - about 3-6 months, and full recovery might need up to a year. 

4. What are the four types of ankle dislocations?

These are the four main types:

  • Posterior - Most common, where the talus shifts backwards (forced plantar flexion)
  • Anterior - Happens when the foot moves forward or with forced dorsiflexion
  • Lateral - Comes from forced inversion/eversion, always with malleolar fractures
  • Superior - Occurs when the talus gets pushed upward into the mortise

5. Do I need surgery for an ankle dislocation?

You will need surgery if:

  • Your dislocation includes fractures 
  • Closed reduction fails to put the bones back properly
  • The dislocation causes skin tenting or breaks the skin
  • Your joint stays unstable after reduction

6. What is the immediate treatment for a dislocated ankle?

Emergency care must include:

  • RICE method: Rest, ice, compression and elevation 
  • Strong pain medication
  • Quick reduction (putting bones back in place) under sedation
  • Splints to keep it still
  • X-rays after reduction to check alignment

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