Ankle Dislocation

ExitCare ImageAnkle dislocation is the displacement of the bones that form your ankle joint. The ankle joint is designed for a balance of stability and flexibility. The bones of the ankle are held in place by very strong, fibrous tissues (ligaments) that connect the bones to each other.

CAUSES

Because the ankle is a very strong and stable joint, ankle dislocation is only caused by a very forceful injury. Typically, injuries that contribute to ankle dislocation include broken bones (fractures) on the inside and outside of the ankle (malleoli).

RELATED COMPLICATIONS

Ankle dislocation can lead to more serious complications. Examples of complications associated with ankle dislocation include:

  • Injury to the strong fibrous tissues that connect muscles to bones (tendons).

  • Injury to the flexible tissue that cushions the bones in the joint (cartilage). This can lead to the development of arthritis, loss of joint motion, and pain.

  • Injury to the nerves and blood vessels that cross the ankle. Blood vessel damage may result in bone death of the top bone of the foot (talus).

  • Skin over the dislocated area being torn (lacerated) or damaged by pressure from the dislocated bones.

  • Swelling of compartments in the foot (rare). This may damage blood supply to the muscles (compartment syndrome).

RISK FACTORS

Although dislocation of the ankle can occur in anyone, some people are at greater risk than others. People at increased risk of ankle dislocation include:

  • Young males. This may be related to their overall increased risk of injury.

  • Postmenopausal women. This may be related to their increased risk of bone fracture because of the weakening of the bones that occurs in women in this age group (osteoporosis).

  • People born with greater looseness (elasticity) in their ligaments.

SYMPTOMS

Symptoms of ankle dislocation include:

  • Severe pain.

  • Swelling.

  • Deformity around the ankle.

  • Whitening or laceration of the skin.

DIAGNOSIS

A physical exam and an X-ray exam are usually done to help your caregiver diagnose ankle dislocation.

TREATMENT

Treatment may include:

  • Manipulation of the ankle by your caregiver to put your ankle back in place (reduction).

  • Repair of any associated skin lacerations.

  • Plates and screws used to stabilize the fractures and hold the joint in position after reduction.

  • Pins drilled into your bones that are connected to bars outside of your skin (external fixator) used to hold your ankle in a fixed position until the swelling in your ankle goes down enough for surgery to be done.

  • Placement of a cast or splint to allow torn ligaments to heal.

  • Physical therapy to regain ankle motion and leg strength.

HOME CARE INSTRUCTIONS

The following measures can help to reduce pain and hasten the healing process:

  • Rest your injured joint. Do not move it. Avoid activities similar to the one that caused your injury.

  • Apply ice to your injured joint for 1 to 2 days after your reduction or as directed by your caregiver. Applying ice helps to reduce inflammation and pain.

  • Put ice in a plastic bag.

  • Place a towel between your skin and the bag.

  • Leave the ice on for 15 to 20 minutes at a time, every couple of hours while you are awake.

  • Elevate your ankle above your heart to minimize swelling.

  • Move your toes as instructed by your caregiver to prevent stiffness.

  • Take over-the-counter or prescription medicines for pain as directed by your caregiver.

SEEK IMMEDIATE MEDICAL CARE IF:

  • Your cast, splint, screws, plates, or external fixator becomes loose or damaged.

  • You have an external fixator and you notice fluids draining around the pins.

  • Your pain becomes worse rather than better.

  • You lose feeling in your toe or cannot bend the tip of your toe.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.