By Kathryn Trumble, DPT, ATC
An ankle dislocation is a severe ankle injury which requires immediate medical attention. A dislocation is a separation of 2 or more bones that create a joint. An ankle dislocation can occur in sporting events or even with “trip and fall” injuries.
The ankle consists of 3 main bones that come together to form the ankle or talocrual joint.
- Tibia: Larger shin bone that is the top of the ankle joint and extends down to the inside part of the ankle.
- Fibula: Smaller shin bone that extends down to the outside part of the ankle.
- Talus: Smaller bone that sits between the tibia and fibula.
The ankle is a stable joint due to the structure of the joint. The talus sits like a keystone between the tibia and fibula, allowing for the foot to move up and down. These movements are called plantarflexion and dorsiflexion and are required for any standing or walking activity. The ankle is also stabilized by many ligaments and muscles/tendons. These structures can be stretched or torn during this type of injury.
An ankle dislocation occurs by a significant injury. Below are a few causes of an ankle dislocation.
- Trip and fall causing the ankle to be pointed and rolled.
- Significant blow during a sporting activity.
- Quick and sudden change in direction with sports.
- Motor vehicle accident.
Signs and Symptoms
These can include but are not limited to the following:
- Significant pain in the foot/ankle.
- Difficulty putting weight on the foot/ankle.
- Significant swelling/heat in the area.
With a deformity, no additional diagnostics may be needed. For less severe injuries with no deformity, imaging such as an X-ray or CT scan/MRI may be necessary. In addition to just diagnosing the dislocation, imaging may be needed to assess any soft tissue injuries or fractures.
If you have any of the signs and symptoms listed above, seek immediate medical attention. It is best to try to splint or protect the ankle and no put weight on the foot/ankle. If you are diagnosed with an ankle dislocation you will most likely need surgery to relocate the bone. In some cases, other bone or soft tissues will be damaged and these structures will need to be fixed with surgery.
- Following surgery, you will be placed in a cast or walking boot to give your injured ankle support. You will also not be able to put weight into the injured leg, so crutches, a walker, and a scooter will be needed.
- During this time, you may attend physical therapy, depending on the severity of the injury and your medical doctor’s preferences.
- Once you are allowed to start putting weight into the injured leg, you will need to re-learn how to walk correctly.
- Physical therapy will be needed to help with walking, strengthen the ankle/leg, and help with balance.
Long term considerations
- You may have residual stiffness in the ankle; especially if you fractured a bone and needed the fracture repaired.
- You may also have residual loosening on the soft tissues (ligaments/tendons/muscles) due to these being stretched during the injury
- Healing times are different from person to person. It is important to follow the direction of medical professionals for optimal healing. Poor diet, smoking, diabetes, and other health problems can lead to slower healing times and slower recovery!
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Author: Kathryn Trumble, DPT, ATC