How to Diagnose an Ankle Dislocation

An ankle dislocation occurs when the articular surfaces in the ankle lose opposition. This requires significant force and is usually accompanied by a fracture. An ankle dislocation also may disrupt ligaments and neurovascular injury is a concern. Young males are the most common group for this injury, but postmenopausal women are also at increased risk due to the loss of bone mass.

Instructions

Difficulty: Moderate

1. Determine the specific type of dislocation. This is needed because the ankle may need to be pushed back into its proper position with a force opposing the one that caused the dislocation.
2. Identify a posterior dislocation as the most common. Force drives the foot backward to move the ankle posterior to the distal tibia. The joint widens when the anterior ankle is wedged back. This is accompanied by a fracture of the lateral malleolus or a disruption of the tibiofibular syndesmosis.
3. Recognize the other types of ankle dislocation. They are named for the direction of force required to cause the dislocation and include anterior, lateral and superior dislocations.
4. Examine the ankle dislocation visually. Significant swelling with deformity should be present and the skin may be tented by the malleoli. The joint will be tender along the joint line indicating the areas of disruption to the ligaments.
5. Obtain radiographs of the affected ankle. Anteroposterior and lateral views are taken with oblique images made at a rotation of 10 to 20 degrees. This angle will provide the best view of the talar dome and tibial plafond.