An ankle dislocation occurs when the bones that form the ankle joint are forced out of their normal alignment. This severe injury involves an abnormal separation between these bones, requiring significant force to disrupt the joint’s natural stability.
Understanding Ankle Dislocation
An ankle dislocation specifically refers to the displacement of the bones within the ankle joint. This joint is comprised of three main bones: the tibia (shinbone), the fibula (the smaller bone in the lower leg), and the talus (a bone in the foot that sits between the tibia and fibula). Normally, strong ligaments hold these bones tightly in place, ensuring proper alignment and function. This injury is distinct from an ankle sprain, which involves stretching or tearing of ligaments, and a fracture, which is a break in the bone. While a pure ankle dislocation without a fracture is less common, dislocations often occur simultaneously with fractures of the surrounding bones or severe ligamentous tears due to the intense forces involved.
How Ankle Dislocations Occur
Ankle dislocations typically result from substantial trauma, as the ankle joint is inherently stable. High-energy impacts are usually necessary to dislodge the bones from their proper position. Common scenarios leading to this injury include high-impact sports activities, falls from significant heights, and motor vehicle accidents. The mechanism of injury often involves extreme forces such as severe twisting, forceful inversion (foot turning inward), or eversion (foot turning outward), especially when the foot is pointed downward (plantarflexed). Axial loading, where a strong force is directed along the length of the leg, can also drive the talus out of alignment, tearing supporting ligaments and allowing the bones to separate.
Identifying an Ankle Dislocation
Severe, often excruciating, pain is typically felt at the moment of injury and persists intensely. The ankle will usually appear visibly deformed or misshapen, as the bones are no longer in their correct alignment. Additionally, there will be an immediate and significant swelling around the joint, often accompanied by rapid bruising or discoloration. A person with an ankle dislocation will find it nearly impossible to bear any weight on the affected foot or move the ankle. In some instances, numbness or tingling in the foot may occur, indicating potential nerve involvement due to the severe displacement.
What to Do After an Ankle Dislocation
If an ankle dislocation is suspected, seek immediate medical attention. Do not attempt to manipulate or “pop” the ankle back into place, as this could cause further damage to nerves, blood vessels, or surrounding tissues. While awaiting professional help, immobilize the ankle in the position it was found. Applying ice, covered with a cloth, for 15 to 20 minutes can help reduce swelling and pain, and elevating the injured limb above the heart helps minimize swelling. A healthcare professional will perform a “reduction,” which is the manual realignment of the bones, often requiring sedation or anesthesia to relax the muscles and alleviate pain. Imaging, such as X-rays, is used to confirm the bones are properly realigned and to check for associated fractures; following reduction, the ankle will be immobilized with a splint or cast, and physical therapy will be necessary for rehabilitation.