An ankle dislocation occurs when the bones forming the ankle joint are forced out of their normal alignment. This severe injury requires careful attention to ensure proper healing and reduce the risk of long-term complications.
What an Ankle Dislocation Is
The ankle joint consists of three main bones: the tibia (shinbone), the fibula (the smaller bone alongside the tibia), and the talus (a bone in the foot that sits between the tibia and fibula). Normally, these bones articulate smoothly, allowing for foot movement.
This injury differs from a sprain, which involves stretching or tearing the ligaments that connect bones without bone displacement. While a sprain can cause instability, a dislocation means the joint surfaces are no longer aligned. Ankle dislocations are also distinct from fractures, which are breaks in the bone itself. However, dislocations often occur alongside fractures.
Recognizing an Ankle Dislocation
Ankle dislocations result from significant trauma, such as high-impact forces, severe twists, or falls from a height. Sports injuries, particularly in activities like football, hockey, or soccer, and motor vehicle accidents are common causes. An unexpected change in how the foot strikes the ground can also cause the ankle to twist severely, leading to dislocation.
Symptoms of an ankle dislocation are immediate. Individuals experience severe pain and may hear a popping sound at the time of injury. There is an obvious deformity of the ankle. Other signs include swelling, bruising, an inability to bear weight on the injured foot, and difficulty moving the ankle. Numbness or tingling in the foot can also occur if nerves are affected.
Immediate Steps and Medical Care
If an ankle dislocation is suspected, take immediate steps before professional medical help arrives. Do not attempt to move the joint or force it back into place, as this can cause further damage to surrounding tissues, nerves, or blood vessels. Instead, immobilize the ankle using a splint or firm support to prevent movement. Elevating the injured ankle above heart level can help reduce swelling. Applying ice or a cold pack to the area for 10 to 20 minutes at a time, with a thin cloth between the ice and skin, can also help manage pain and swelling.
Immediate medical attention is important for an ankle dislocation. Medical professionals will perform a physical examination and take X-rays to confirm the dislocation and check for any associated fractures. In some cases, if there’s concern about nerve or blood supply damage, attempts to realign the ankle might be made before X-rays.
The process of putting the bones back into their proper alignment is called “reduction.” This procedure may involve manual manipulation by a doctor, sometimes under sedation to help relax the muscles and manage pain. Following reduction, the ankle is immobilized in a splint or cast.
Recovery and Future Protection
After reduction, care involves immobilization, often with a cast or boot, for several weeks to allow healing. Pain management will continue, and the ankle should be kept elevated and iced to control swelling. It is important to avoid putting weight on the ankle during this initial healing phase, and crutches or other assistive devices may be necessary for mobility.
Physical therapy plays an important role in the recovery process to restore strength, flexibility, and balance. Rehabilitation progresses through phases, starting with gentle range-of-motion exercises and gradually advancing to weight-bearing activities, strengthening exercises, and balance training. The overall recovery time can vary, ranging from 8-12 weeks for mild to moderate dislocations without a fracture, to 3-6 months or longer if surgery or a fracture is involved.
Potential complications can arise if an ankle dislocation is not treated properly, including ankle instability, chronic pain, and the development of arthritis in the joint. To reduce the risk of future ankle injuries, continue strengthening exercises, especially for the muscles around the ankle. Wearing appropriate footwear, being cautious during physical activities, and addressing any underlying issues like muscle weakness can also help protect the ankle.