Dislocated Ankle (Ankle Dislocation)

Dislocations are painful, and there is usually obvious deformity of the ankle joint. It may be very difficult or impossible to stand or walk.

If the nerves that run across the ankle joint are damaged or inflamed, there can be numbness and tingling of the foot.

There is almost immediate swelling of the ankle joint area and ecchymosis (bruising) may occur quickly.

Depending upon the mechanism of injury, there can be associated other injuries of the foot, knee, or spine.

It is important for the health-care professional to take a history as to how the injury occurred. Appreciating the mechanism helps makes sense of the injury and may help direct treatment. Past medical history and previous ankle injury may provide useful information.

The dislocated ankle is often diagnosed clinically by the appearance of the ankle. Physical examination can determine the abnormal relationship of the tibia, fibula, and talus. In addition to the ankle, the health-care professional may also exam the structures of the foot and knee, looking for other potential associated injuries.

Because blood vessels and nerves can become stretched and damaged when the ankle dislocates, pulses and sensation in the foot are evaluated. Skin complications are common because as the skin stretches over a bony prominence when the ankle is dislocated, it can lose its blood supply and die.

X-ray is the initial diagnostic test used to determine the extent of injury, where the bones are in relation to each other and whether a fracture is present. Once the dislocation is reduced and the bones realigned, another post-reduction X-ray may be done to confirm that realignment is good (bones in normal position). Depending upon the situation, CT or MRI scans might be considered to evaluate damage to the joint surface, to look for occult or hidden fractures, and to assess the ligaments and tendons that surround and stabilize the ankle joint.