Treatment of open ankle dislocation without associated fractures in a young athlete using external fixation and ligament repair with suture tape augmentation

Abstract

Background: Ankle dislocation without fracture is an extremely rare injury because it is usually accompanied by concomitant malleolar fractures from the anatomical and mechanical viewpoints. Case presentation: We report the case of a 17-year-old woman who was injured while playing basketball. Her ankle was swollen and deformed. Plain X-ray revealed tibiotalar dislocation in the medial direction without any fractures. Immediate reduction and ligament repair using suture tape augmentation were performed. Conclusions: At 5 months postoperatively, the patient returned to playing basketball without any complaints. After an additional 2 months, the patient participated and played in the Winter Cup 2019 (the national high school basketball tournament in Japan) at the previous performance level.

Pure antero-superior tibio-talar dislocation without fracture in the setting of severe soft tissue injury: A case report

“…The repair of the lateral ligament is the most controversial issue especially in open injuries. 5,7,8,10 Elise et al recommended an acute repair in open injuries. 11 In contrast, in the systematic review of Wight et al, acute ligament repair has been done in 26% and they concluded that it didn't influence ankle instability.…”

“…Most authors recommend immobilization with non-weight bearing of a mean period of 6 weeks, while others described some cases with good outcome after progressive mobilization with full weight bearing after only 2 weeks. 1,7 Those who preferred shorter duration of immobilization considered that this will decrease the incidence of stiffness, which is the most common complication of pure ankle dislocation. 1,7 On the other hand, the choice of the immobilization device didn't prove to affect ankle stiffness or instability.…”

“…1,7 Those who preferred shorter duration of immobilization considered that this will decrease the incidence of stiffness, which is the most common complication of pure ankle dislocation. 1,7 On the other hand, the choice of the immobilization device didn't prove to affect ankle stiffness or instability. 1 In conclusion, we need further research on immobilization type and length in order to improve patient outcomes.…”

“…4 Due to the rarity of this condition, no clear therapeutic guidelines have been established. 1,5,6,7,8 Whatever was the treatment options chosen, early reduction and stabilization with the shortest period of immobilization were the most important factors to achieve good clinical outcomes. 1,7 We report herein, a rare case of anterior superior pure ankle dislocation associated with degloving injury of the leg in the absence of any fracture where we present a review of literature of similar case, and we discuss mechanism of injury and available treatment options.…”

An extremely rare combination of open dislocation of the ankle with superior type anterior hip dislocation without bone fracture: A case report

“…8 There was a large open wound with grossly exposed bones happened at farmer's field with a high risk of infection, accompanied by extensive soft tissue swelling so we decided to do reduction by delta frame external fixator in comparison to the other reported treatment option like reduction followed by casting. 6,7,9 Subsequently patients improved without infection postoperatively. Due to insufficient study, the outcome of ligament repair is controversial and the reported reports also support the outcome not affected by ligament repair for which reason we did not perform ligament repair.…”