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

Abstract

Dislocation of the ankle without fracture is very uncommon. There are only few reports in the international literature. Up to now approximately 80 cases are published. The risk of hyperflexion and -inversion of the ankle seems high on a trampoline. A multiple of the jumperʼs body-weight projects delayed on the upper ankle joint while dipping in the trampoline-sheet. Reduction should be performed as fast as possible to ensure a good clinical outcome. Imaging via MRI and CT scan allows a detailed evaluation of the injury severity. The decision for further treatment should be based on the findings in the MRI and CT scans. Reconstructing the medial and lateral capsular ligaments can be necessary. With a consequent treatment algorithm a good functional outcome can be achieved. In our case we documented a post-traumatic AOFAS score of 87/100 six months after the injury without an instability of the upper or lower ankle joint. Propioreceptive reflex and pronator training as well as taping seem to be useful before and during trampoline sports.

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

“…The application of drainage apparatus and vacuumassisted closure therapy (VAC) depends on the concrete conditions of the contamination of the wound. External xation is suitable for the primary stabilization of the affected joint [22,23,25,26] especially in open cases with severe compound wound just as we showed in the 5 cases. However, there were two out of ve patients immobilized with external xators complaining of stiffness.…”

“…The literature recommends six-to eight-week immobilization without bearing weight on the concerned extremity [4,21,22]. After that, a gradual increase of load and remobilization therapy can be started adapted to the level of pain and swelling, in which proprioception and pronation training playing an important role [23]. The average 6 weeks immobilization length recommended by the literature may be su cient for ligaments healing and shorter immobilization times may minimize ankle stiffness and ROM loss.…”

“…Preventive measures such as proprioceptive re ex and pronator training seem advisable regarding the injury mechanism [23]. It is possible that high-top shoes and taping of the ankle joint might improve resistance to an inversion injury by limiting the degree of passive inversion and improving the muscle reaction time of the peroneus brevis muscle of unstable ankles [3,48].…”

Open total dislocation of ankle joint without fractures

“…In Ballard study, 64 cases (16.1%) with tendon entrapment or dislocation were diagnosed, and the total incidence of tendon entrapment reached up to 8.3%, with tendon dislocation to 8.5% [7] . Therefore, tendon entrapment and dislocation are not uncommon in such complex injuries and should be considered when dealing with ankle dislocation [8] …”

“…[ 7 ] Therefore, tendon entrapment and dislocation are not uncommon in such complex injuries and should be considered when dealing with ankle dislocation. [ 8 ]…”