Open Dislocation of Ankle without Fracture Treated with an External Fixator

Abstract

Ankle dislocations are orthopedic emergencies that require immediate treatment to avoid neurovascular impairment. They are usually accompanied by one or more comminuted fractures of the ankle mortis. In rare circumstances, such as high-energy trauma, the ankle dislocations may not be accompanied by concomitant malleolar fractures and, thus, are named "pure ankle dislocations". We presented a very rare and interesting case of an open medial dislocation of the ankle without associated fracture in an 18-year-old man with no known predisposing risk factors. The patient was admitted to the emergency department after sustaining a catastrophic trampoline accident resulting in severe inversion of the right ankle. The patient was treated with an external fixator and was mobilized early in the post-surgical course. Despite initial presentation that revealed lack of posterior tibial pulse, the post-surgical course was uneventful, with full functional recovery and joint mobility. The primary goals of treatment are immediate reduction of the joint and relief of neurovascular stress. External fixation is a prompt, fairly easy treatment that one should keep in mind in pure ankle dislocations. Nonetheless, ligamentous restoration and early mobilization were the key elements as seen in our case for full functional recovery.