Galanis Athanasios, Karampinas Panagiotis, Vlamis John, Vavourakis Michail, Papagrigorakis Eftychios, Vlachos Christos, Zachariou Dimitrios, Pneumaticos Spiros
3rd Department of Orthopaedic Surgery, National & Kapodistrian University of Athens, KAT General Hospital, Athens, Greece.
Trauma Case Rep. 2023 Sep 27;48:100935. doi: 10.1016/j.tcr.2023.100935. eCollection 2023 Dec.
Ankle dislocation with no concomitant malleolar fracture is an overwhelmingly rare injury, and only a relatively limited number of cases have been reported. Diligent management regarding the treatment of these injuries is requisite to attain an auspicious outcome. Lateral ankle instability is a frequent condition that can derive from recurrent sprains, predominantly at a young age. Broström repair, with its modifications and updates, has been established as the optimal solution when treating chronic lateral unsteadiness. We present a peculiar case of a posteromedial ankle dislocation without accompanying fracture in a patient operated on many years before the injury for chronic lateral instability with a modified Broström procedure. No similar case could be retrieved in the existing literature. After the initial clinical and radiological assessment, urgent closed reduction of the dislocation was achieved, and the foot was immobilized. Further imaging was carried out to evaluate the features of the injury. It was deduced that the repairs from the previous operation were intact. The patient was operated on to repair the distal tibiofibular syndesmosis. The postoperative course was uneventful, and absolute functional capacity was eventually accomplished. Demonstrating this rare case, we accentuate the role of implementing the modified Broström procedure in the surgical treatment of chronic lateral ankle instability.
无合并内踝骨折的踝关节脱位极为罕见，仅有相对有限的病例报道。对这些损伤进行精心治疗对于取得良好预后是必要的。外侧踝关节不稳是一种常见情况，主要发生于年轻人，多由反复扭伤引起。改良后的布罗斯特罗姆修复术已被确立为治疗慢性外侧不稳的最佳方案。我们报告了一例特殊的后内侧踝关节脱位病例，患者在受伤多年前因慢性外侧不稳接受了改良布罗斯特罗姆手术，此次脱位未合并骨折。现有文献中未检索到类似病例。经过初步临床和影像学评估后，紧急进行了脱位的闭合复位，并固定了足部。进一步的影像学检查用于评估损伤特征。推断先前手术的修复完好。患者接受手术修复胫腓下联合。术后过程顺利，最终恢复了完全的功能能力。通过展示这一罕见病例，我们强调了改良布罗斯特罗姆手术在慢性外侧踝关节不稳手术治疗中的作用。
