Acute Traumatic Open Posterolateral Dislocation of the Ankle Without Tearing of the Tibiofibular Syndesmosis Ligaments

Abstract

Pure open dislocation of the ankle, or dislocation not accompanied by rupture of the tibiofibular syndesmosis ligaments or fractures of the malleoli or of the posterior border of the tibia, is an extremely rare injury. A 62-year-old man injured his right ankle in a motor vehicle accident. Besides posterolateral ankle dislocation, there was a 7-cm transverse skin cut on the medial malleolus, and the distal end of the tibia was exposed. After reduction, we made a 2- to 2.5-cm longitudinal incision on the lateral malleolus; the distal fibular fracture was exposed. Two Kirschner wires were placed intramedullary in a retrograde manner, and the fracture was stabilized. The deltoid ligament and the medial capsule were repaired. The tibiofibular syndesmosis ligaments were intact. At the end of postoperative year 1, right ankle joint range of motion had a limit of approximately 5 degrees in dorsiflexion, 10 degrees in plantarflexion, 5 degrees in inversion, and 0 degrees in eversion. The joint appeared normal on radiographs, with no signs of osteoarthritis or calcification. The best result can be obtained with early reduction, debridement, medial capsule and deltoid ligament restoration, and early rehabilitation. Clinical and radiographic features at long-term follow-up also confirm good mobility of the ankle without degenerative change or mechanical instability.

Closed posteromedial dislocation of ankle in a 12 year-old boy: a case report

“…Ankle fractures and fracture dislocations are common injuries in orthopaedic practice however pure ankle dislocation without an associated fracture is extremely rare [3,5,19]. The rarity is described to be due to mechanical efficacy of the ankle mortise and resistance of the ankle ligaments being greater than bone making fracture common [6].…”

“…Our patient had neither history of previous ankle sprain nor an evidence of ligamentous laxity or a muscle weakness in the physical examination. ‘For evaluating the medial malleolus hypoplasia, the ratio between the length of the medial (B) and lateral (A) malleolus was evaluated by the method of Elisé et al [20] in anteroposterior ankle radiograph and it was found to be in normal ranges (eg:0.62) (Figure 6). ’…”

“…For evaluating the medial malleolus hypoplasia, the ratio between the length of the medial (B) and lateral (A) malleolus evaluated by the method of Elisé et al [20] in anteroposterior ankle radiograph and it was found to be in normal ranges (0.62).…”

A Series of Pure Ankle Dislocations without Associated Fracture: Our Clinical Experience

“…The disruption of deltoid ligament producing a marked decrease in the tibiotalar contact area, thus the severity of a medial injury will determine the reduction of ankle stability [32]. Kaneko et al [29] and Demiralp et al [33] reported that they performed medial capsule and deltoid ligament restoration in posterolateral cases and gained satisfactory follow-up outcome.…”

Open Ankle Dislocation without Associated Malleolar Fracture on a Trampoline. A Case Report

“…Es sind neurovaskuläre Folgeschäden, persistierende Gelenkinstabilitäten, posttraumatische Arthrosen sowie heterotope Ossifikationen der Gelenkkapsel, vor allem nach offenen Verletzungen, beschrieben [2, 5 -7]. Im Folgenden kommt es gehäuft zu einer funktionell irrelevanten Bewegungseinschränkung des OSGs zwischen 0 und 10°für Plantarflexion, In-und Eversion wie auch Dorsalextension [8,9]. Dabei ist das funktionelle Ergebnis bei offenen Luxationen schlechter und die Komplikationsrate höher [6].…”