Open Ankle Dislocation without Associated Malleolar Fracture on a Trampoline. A Case Report

Abstract

Dislocation of the ankle without fracture is very uncommon. There are only few reports in the international literature. Up to now approximately 80 cases are published. The risk of hyperflexion and -inversion of the ankle seems high on a trampoline. A multiple of the jumperʼs body-weight projects delayed on the upper ankle joint while dipping in the trampoline-sheet. Reduction should be performed as fast as possible to ensure a good clinical outcome. Imaging via MRI and CT scan allows a detailed evaluation of the injury severity. The decision for further treatment should be based on the findings in the MRI and CT scans. Reconstructing the medial and lateral capsular ligaments can be necessary. With a consequent treatment algorithm a good functional outcome can be achieved. In our case we documented a post-traumatic AOFAS score of 87/100 six months after the injury without an instability of the upper or lower ankle joint. Propioreceptive reflex and pronator training as well as taping seem to be useful before and during trampoline sports.

Key words

ankle dislocation without fracture - open ankle dislocation - trampoline - treatment algorithm

Publikationsverlauf

Artikel online veröffentlicht:
09. September 2019

• References/Literatur

• 1 Rivera F, Bertone C. Pure dislocation of the ankle. Clin Orthop Relat Res 2001; (382) 179-184
• 2 Wight L, Owen D, Goldbloom D. et al. Pure ankle dislocation: a systematic review of the literature and estimation of incidence. Injury 2017; 48: 2027-2034
• 3 Sayit E, Sayit AT, Zan E. Open dislocation of ankle without fracture treated with an external fixator. Orthop Surg 2017; 9: 247-251
• 4 Bakshi K. Open axial and true vertical ankle dislocation without malleolar fractures: a case report. J Foot Ankle Surg 2016; 55: 176-180
• 5 Lui TH, Chan KB. Posteromedial ankle dislocation without malleolar fracture: a report of six cases. Injury 2012; 43: 1953-1957
• 6 Toohey JS, Worsing jr. RA. A long-term follow-up study of tibiotalar dislocations without associated fractures. Clin Orthop Relat Res 1989; (239) 207-210
• 7 Dlimi F, Mahfoud M, Berrada MS. et al. Open medial ankle dislocation without associated fracture: a case report. Foot Ankle Surg 2011; 17: e55-e57
• 8 Demiralp B, Komurcu M, Ozturk C. et al. Acute traumatic open posterolateral dislocation of the ankle without tearing of the tibiofibular syndesmosis ligaments: a case report. J Am Podiatr Med Assoc 2008; 98: 469-472
• 9 Georgilas IG, Mouzopoulos GM. Anterior ankle dislocation without associated fracture: a case with an 11 year follow-up. Acta Orthop Belg 2008; 74: 266-269
• 10 Tarantino U, Cannata G, Gasbarra E. et al. Open medial dislocation of the ankle without fracture. J Bone Joint Surg Br 2008; 90: 1382-1384
• 11 Karampinas PK, Kavroudakis E, Polyzois V. et al. Foot and ankle surgery open talar dislocations without associated fractures. Foot Ankle Surg 2014; 20: 100-104
• 12 Shaik MM, Tandon T, Agrawal Y. et al. Medial and lateral rotatory dislocations of the ankle after trivial trauma–pathomechanics and management of two cases. J Foot Ankle Surg 2006; 45: 346-350
• 13 Wohlrath B, Schweigkofler U, Hoffmann R. Präklinische Versorgung von Extremitätenfrakturen und Luxationen. Notfallmedizin up2date 2015; 10: 61-73
• 14 Breccia M, Peruzzi M, Cerbarano L. et al. Treatment and outcome of open dislocation of the ankle with complete talar extrusion: a case report. Foot (Edinb) 2014; 24: 89-93
• 15 Lazarettos I, Brilakis E, Efstathopoulos N. Open ankle dislocation without associated malleolar fracture. J Foot Ankle Surg 2013; 52: 508-512
• 16 Bae BJ, Baker JF, Orec RJ. et al. Open ankle dislocation without fractures with tibialis posterior tendon interposition through the interosseous space. J Foot Ankle Surg 2017; 56: 1109-1113
• 17 Schmidmaier G, Ferbert T, Meenen NM, Schütz M. S2e-Leitlinie Sprunggelenkfraktur (AWMF-Registernummer 012/003; 12.05.2015). Im Internet (Stand: 15.06.2018): https://www.awmf.org/uploads/tx_szleitlinien/012-003l_S2e_Sprunggelenkfraktur_2016-02.pdf
• 18 Anderson A, Miller AD, Brandon Bookstaver P. Antimicrobial prophylaxis in open lower extremity fractures. Open Access Emerg Med 2011; 3: 7-11
• 19 Grote S, Polzer H, Prall WC. et al. Prävention von Infektionen bei offenen Frakturen heute. Orthopäde 2012; 41: 32-42
• 20 Arora V, Kimmel LA, Yu K. et al. Trampoline related injuries in adults. Injury 2016; 47: 192-196
• 21 Liebhauser M, Brunner S, Antoniadis A. Luxation des oberen Sprunggelenks ohne ossäre Läsion. Unfallchirurg 2019; 122: 238-242
• 22 Rammelt S, Schneiders W, Grass R. et al. Bandverletzungen am oberen Sprunggelenk. Z Orthop Unfall 2011; 149: e45-e67