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Dislocation of the ankle joint – this is a displacement of the ankle joint due to a rupture of the ligaments. It happens that the joint is not fully displaced, and the ligaments are not completely torn. This condition is medically referred to as subluxation. It happens that the ligaments do remain intact, but at the same time the joint is displaced, this condition is called a dislocation without tearing the muscles.
Dislocation of the ankle is a fairly common situation. At risk are people of retirement age, due to the fragility of the bones. Also, athletes often suffer from dislocations, which is associated with the nature of their professional activity and women who prefer wearing high-heeled shoes. But no one is immune from getting such an injury both at home and at work.
Types of dislocations of the ankle joint
In medical practice, it is customary to distinguish the following types of dislocations of the ankle joint:
Incomplete or partial tearing of ligaments. Most often, it is the anterior peroneal muscles that are injured, but sometimes the deltoid, and calcaneal-fibular, and tibiofibular muscles also suffer.
The muscle tear in the ankle is strong. This type of dislocation is characterized by the fact that the leg does not lose its mobility, but nevertheless a swelling forms, when a person feels the damaged area, he complains of pain. Most often, blood accumulates in places of damage.
Complete rupture of ligaments with dislocation of the joint. This condition is accompanied by severe swelling and pain. The man is unable to step on his foot. Internal bruising is clearly visible in the ankle area.
In any and these conditions, the victim should be shown to the doctor as soon as possible.
Also, due to the occurrence, dislocations can be divided into two groups:
Acquired, which are post-traumatic (those that were formed due to an injury), pathological (those that are the result of joint pathology), paralytic (those that appear as a result of severe muscle paralysis), habitual (those that occur regularly).
Congenital.
Causes of dislocation of the ankle joint
Among the direct causes leading to dislocation of the ankle, the following can be distinguished:
Careless turn.
The fall.
Inaccurate landing on the foot.
Hit.
But besides this, there are a number of other factors that contribute to the formation of such an injury:
High arch of the foot.
Weak ligaments that loosen up with age due to lack of regular training.
Underdevelopment of the peroneal muscles.
The presence of even a slight sprain.
Neuromuscular disorders.
Walking disorders. If the foot is placed incorrectly, the muscles weaken over time, which can lead to a dislocation of the joint.
Also, some diseases can cause weakening of the ligaments, a decrease in bone density, as well as an increase in the load on the leg:
Obesity and, consequently, diabetes.
Oncological diseases.
Tuberculosis.
Osteomyelitis and arthrosis.
Inflammation of ligaments and tendons.
Muscle paresis.
Congenital pathologies leading to the fact that during intrauterine development in the fetus, the correct formation of the ankle is disturbed. But it is worth noting that such dislocations are extremely rare.
Symptoms of a dislocated ankle
The symptoms of a dislocation are very similar to those of a common bruise. That is why it is necessary to consult a doctor for a more accurate diagnosis.
But with a dislocation, all the symptoms are more pronounced:
Sharp unrelenting pain. It increases with palpation of the damaged area. In this case, the pain may not appear immediately, or it may not be too intense. But after a while it will grow.
Inability to stand up due to severe pain.
Significant edema and swelling in the lower leg and foot.
Upon injury, a characteristic crack or click was heard.
The formation of a bright hematoma, located not only on the lower leg, but also on the foot.
Diagnosis of dislocation of the ankle joint
When contacting a traumatologist for a patient complaining of characteristic pain in the ankle area, the doctor will first of all perform a visual examination and palpate the damaged area.
To clarify the diagnosis, the doctor will most likely prescribe an X-ray or an ultrasound scan. The picture is taken in two projections. Sometimes, when there is a risk that the dislocation has formed chips, arthrography of the ankle may be prescribed.
Treatment of dislocation of the ankle joint
Naturally, when a dislocation occurs, the doctor is often not around. Therefore, it is worth knowing how to provide first aid yourself. First you need to remove shoes and socks from the sore leg in order not to compress the resulting swelling. After that, you should put the injured limb on a pillow or roller and fix it in one position with the help of any bandage or bandage.
To achieve this goal, even an ordinary scarf can be suitable. If a bandage is applied, it is better to first wrap the diseased joint with a layer of cotton wool. Do not overtighten the bandage. It should fit snugly to the leg, but not block the blood flow in it. With a frequency of a couple of hours, ice can be applied to the joint to relieve symptoms and relieve swelling.
A complete list of measures for the treatment of dislocation of the ankle consists in the imposition of an immobilizing bandage, which allows the limbs to rest in one position. In the first three days, you can apply cold, after which warm compresses are used. For this purpose, you can always use special ointments for bruises and sprains. In addition to the therapeutic effect, it relieves pain to some extent and reduces swelling. They may include any analgesics, methanol (for cooling) and alcohol (for heating).
Sometimes a dislocated joint may need to be repositioned. It should be understood that this is a complex and responsible event that can only be carried out in a medical institution. In order to put the joint in place, doctors use local or epidural anesthesia. When the bone is repositioned, another x-ray is needed for control purposes. Sometimes a small incision needs to be made to perform manipulations on reduction. If the dislocation is repeated repeatedly, then this may lead to the fact that the patient will need a total joint replacement.
If the reduction of the bone was successful, but an incision was made for this, then the patient is discharged from the clinic on the 5th day, when the swelling subsides. But at the same time, a plaster cast will be applied to the leg, which will have to be worn for at least a month.
After the pain has passed, you can begin to visit the pool. This is very useful for strengthening the muscles of the ankle.
But even if the dislocation seems quite insignificant, you should still show the damaged area to the doctor. It is the timely prescribed therapy and examination by a professional that will give a positive result in the aggregate. If pain is not well tolerated by the victim, then ibuprofen or ketoral can be used to eliminate them. It is advisable to take it twice a day, in a dosage corresponding to body weight and age.
Analgin, pentalgin, aspirin can also help. It should be understood that a serious sprain can be several times worse than a fracture with its consequences. That is why every experienced doctor, before prescribing this or that treatment, always establishes the degree of their damage. If in light sprains it is enough to apply a regular bandage, then in severe sprains, the leg is immobilized. The duration of wearing a bandage can be even a month. Left untreated, the ankle joint can become chronically unstable.
As auxiliary means for the treatment of dislocation, the following procedures can be distinguished:
The appointment of electrophoresis.
The imposition of paraffin applications.
Diadynamotherapy.
Cryotherapy.
Taking foot baths with radon.
Folk remedies are effective, which help the sore leg recover faster.
For treatment, you can use the following means:
Taking foot baths, decoctions of various herbs are used as filling for them. Infusions of celandine and calendula have proven themselves well.
You can make an effective compress at home and take equal parts of laundry soap, ammonia, oil and dry camphor. It is necessary to impose on a sore spot and withstand at least 15 minutes.
You can make lotions with apple cider vinegar, diluted with water by half.
It is also recommended to apply grated fresh potatoes and make healing clay wraps.
Recovery and lifestyle after a dislocated ankle
To restore and strengthen the ligaments, doctors without fail recommend physical therapy classes.
The complex includes:
Whenever possible, the patient should perform active movement of the toes.
Rolls from socks to heels and back.
Walking with heels pointing in and out.
Rolling the cylinder or any of its substitutes.
Exercises on an exercise bike.
Swimming.
After the ankle muscles are strengthened, you can move on to more active exercises – to run and jump.
In any case, before giving the affected leg a heavy load, you should first consult with the doctor about whether this will harm the joint. As physiotherapeutic procedures, UHF is most often prescribed. Treatment with an electric field is carried out in 10 sessions, lasting a quarter of an hour.
Depending on the degree of injury to the joint, a full load on the leg can be given in mild cases after a month, and in severe cases – after three months. Naturally, it is rather problematic for a person to stay for such a long time, so it is possible to use crutches. In this case, it is advisable to wear special shoes or arch supports, for up to a year.
Preventive measures that must be observed in order to protect yourself as much as possible from dislocation of the ankle joint are as follows:
Wearing stable shoes, if possible, with a small heel.
Compliance with safety regulations in sports and in the workplace and caution when moving on slippery surfaces.
The use of bandages, elastic bands and other devices during sports.
Sports activities to strengthen the muscles of the lower extremities.
If you suspect a dislocation of the joint – immediately seek medical help.
Timely treatment of diseases leading to the risk of ankle dislocation.
As for the prognosis, if you quickly seek professional help, it is favorable. If you strictly follow all the appointments made by the attending doctor, then the recovery will take place in the shortest possible time. With a slight stretching, the sick leave is closed within a week. If the ligament is severely damaged or torn, and the joint had to be inserted using surgical methods of treatment, then the doctor leaves the patient on sick leave until the end of the rehabilitation period.
Sequelae of a dislocated ankle
It often happens that an ankle injury is accompanied by a complete detachment of the ligament and fractures of the ankle. In such cases, timely seeking medical help is important, because a delay or self-treatment can lead to the fact that the tendons and ligaments do not grow together correctly, the foot is deformed, which guarantees its instability.
Against this background, the following problems may arise:
Regularly recurring dislocations of the ankle joint.
The progression or onset of the development of diseases such as arthrosis or arthritis.
Formation of scar tissue of a dense consistency.
Formation and growth of bone osteophytes.
Difficulty in the mobility of the damaged joint after its healing.
Inflammation of the soft tissues surrounding the ankle.
Hemarthrosis, which is chronic.
Complete or partial muscle atrophy, circulatory disorders in the limbs.
It should be understood that neglected cases can only be rehabilitated by surgery, otherwise a person may forever remain disabled.