Abstract
Background
Ankle dislocation without fracture is rare. We used electronic hospital records to
determine the incidence of pure ankle dislocation and performed a systematic review
of the literature to investigate the occurrence, treatment and outcome of this injury
to better inform treating clinicians.
Methods
A review of electronic medical records at a tertiary referral centre was conducted
to estimate in incidence of pure ankle dislocation. Systematic review of the literature
was undertaken according to PRISMA guidelines for the reporting of individual patient
data. This identified 64 English language articles that included 18 case series, 45
case reports and 1 biomechanical cadaveric study. Data was extracted by standard form
independently by 2 of the authors and descriptive statistics were used to describe
results.
Results
The estimated incidence of pure ankle dislocation is 0.065% (13/20,000) of presentations
with an ankle injury or 0.46% (23/5000) of presentations with an ankle dislocation.
Systematic review of English literature identified 154 cases and demonstrated that
sporting accidents (31%) and motor vehicle accidents (30%) are the most common cause.
73% (112/154) of the cases occurred in males and 50% (77/154) were open. In 46% (71/154)
of patients the direction of dislocation was posteromedial. 46% of patients had nonoperative
treatment; ligamentous repair was described in 26% (37 patients). The mean period
of immobilisation was just over 6 weeks (range 2–16 weeks). In most patients, good
functional outcomes were described. The most common long-term complaint was decreased
ankle range of motion (18%) (27/154). Ankle instability was rare (2.6%) (4/154) and
not influenced by acute ligament repair (P = 0.98).
Conclusion
Pure ankle dislocation is a rare injury. The literature reports that most injuries
occur in sports and motor vehicle accidents. The majority of injuries treated with
early reduction followed by a short period of immobilisation and functional rehabilitation
have good clinical outcomes.
Keywords
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Article info
Publication history
Published online: August 12, 2017
Accepted:
August 5,
2017
Identification
Copyright
© 2017 Elsevier Ltd. All rights reserved.
