Sayit Emrah, Sayit Asli Tanrivermis, Zan Elcin
Department of Orthopaedics and Traumatology, Samsun Education and Research Hospital, Samsun, Turkey.
Faculty of Medicine, Department of Radiology, Ondokuz Mayis University, Samsun, Turkey.
Orthop Surg. 2017 May;9(2):247-251. doi: 10.1111/os.12292. Epub 2017 Jan 12.
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.
踝关节脱位是需要立即治疗以避免神经血管损伤的骨科急症。它们通常伴有踝关节 mortis 的一处或多处粉碎性骨折。在罕见情况下,如高能量创伤,踝关节脱位可能不伴有内踝骨折,因此被称为“单纯踝关节脱位”。我们报告了一例非常罕见且有趣的病例,一名18岁男性,无已知易感危险因素,发生开放性内侧踝关节脱位且无相关骨折。患者在遭受灾难性蹦床事故导致右踝严重内翻后被送入急诊科。患者接受了外固定架治疗,并在术后早期进行了活动。尽管最初表现显示胫后动脉搏动消失,但术后过程顺利,功能完全恢复,关节活动度良好。治疗的主要目标是立即复位关节并缓解神经血管压力。外固定是一种迅速且相对简单的治疗方法,在单纯踝关节脱位时应予以考虑。尽管如此,如我们病例所示,韧带修复和早期活动是实现完全功能恢复的关键因素。