Dislocated ankle (ankle): treatment and symptoms
What to do when sprained ankle? Symptoms, treatment and recovery
Every joint in the body a role in helping us to move and perform fine manipulation. The ankle joint represents the articulation between the ankle and foot, fastened by elastic ligaments. Owing to the strong mechanism of the body weight transferred on a particular axle, allowing us to move freely and confidently.
A dislocated ankle is an injury in which there is displacement of the articular surfaces relative to each other with or without ligament rupture. When a partial displacement is called a subluxation.
Causes of injury
Trauma may occur, as when performing domestic manipulations, and during the occupation of all types of sports. The main mechanisms of injury are:
- the exposure of the foot outward or inside;
- the sudden movements of the foot while the ankle joint in a fixed physiologic position;
- the displacement of the foot back in parallel arrangement to the surface of the earth (for example, when a person sharply to catch the fingers of the obstacle).
Remember, as they say in the famous film «Fell, woke up, gypsum.» Here is the same picture: one wrong move — dislocation of the ankle. Consider the situation that contribute to this type of injury:
- Sports injuries associated with Jogging, jumping, jerky movements (athletics, skydiving, gymnastics, parkour, etc.).
- Careless movements that are not associated with sport. This files most often occur when you slip on the ice and failed landing, with incorrect fixation of the limbs during transport on uneven surfaces, wearing shoes with high heels, and when stumbling on an obstacle fingers of the foot.
- Situation, reducing the strength of the ankle joint. Older age decreases the elasticity of ligaments and weakening of the muscles and diseases: osteoarthritis, osteomyelitis, tuberculosis of bone, obesity, cancer education, etc.
Classification of sprains
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Depending on side of offset
- Front dislocation occurs when a strong blow to the lower third of the leg in the back with a fixed sole with a violent or sudden flexion of the foot at the dorsal side.
- Posterior dislocation occurs when a strong blow to the lower third of the leg in the front with fixed soles or dramatically violent flexion of the foot in plantar side.
- External dislocation occurs with dislocation of foot outward and sideways, this condition is accompanied by a fracture of the lateral malleolus.
- Internal dislocation — occurs when there is dislocation of the foot inwards, this condition can be combined with a fracture of the medial malleolus.
- The upper dislocation occurs when you fall from a height (very rare).
- Stage 1 — break the individual fiber bundles;
- Stage 2 — there is a slight ligament tear;
- Stage 3 — complete separation of the ligament from the bone to which it is attached.
Depending on the time of the injury
- Fresh — less than three days;
- Stale — it took about 2 weeks;
- Old — it took more than 2 weeks, this injury requires open surgical reduction, as during this time the surrounding tissues have lost their properties, and there was a growth of connective tissue.
Symptoms, which is typical for injuries
Having come on reception to the surgeon, the patient will tell the exact time of injury, because this state occurs abruptly and is accompanied by a set of symptoms. A dislocated ankle accompany these symptoms:
- Pain character acute increases with movement of the ankle joint or palpation.
- Change the appearance of the joint — form is deformed, sometimes noticeable uncharacteristic bony prominences or felt on palpation.
- Instability of the ankle — even with a slight subluxation of the joint to be in a sensitive state, so even a small load leads him to a state of dislocation.
- Stiffness of the ankle — in case of incorrect mapping of the articular surfaces, the function of the joint is broken and impossible to fully distinctive movement.
- Increase in the volume of joint — soft tissue swelling gives the foot a distinctive look: local swelling, redness or damage to the vessel — bleeding (sometimes hemarthrosis).
- The inability to make any movement in the joint due to increased pain. Foot becomes a forced situation. When you try to become on the foot there is a sharp pain.
- Most people during dislocation may notice a characteristic crunch, which corresponds to the rupture of the ligament.
- Habitual dislocation of the ankle joint is not accompanied by severe pain and only slight soreness at the site of injury.
The clinical picture is specific, depending on severity:
- 1 degree ankle appears a small swelling, the patient complains of mild pain when walking, but the function of the joint is not violated.
- 2 the degree of swelling occupies a large area compared to the 1st degree and typically extends across the outer surface of the foot. The pain disturbs the patient not only with walking but also at rest. Movement in the joint difficult.
- Stage 3 — in the complete rupture of the ligaments will be observed displacement of the articular surfaces relative to each other, so the foot is deformed. Edema and hemorrhage are distributed on the whole foot. Movement in the joint is impossible, and the slightest mechanical stress provokes severe pain.
Any disease requires consistent action, in our case they are:
- medical history — need to figure out how the injury has occurred (i.e., the mechanism), the main complaints of the patient and how long ago it happened. It is important to differentiate primary and recurrent dislocation, because the treatment will vary;
- the objective of the study — toes of a doctor can describe half of the picture of any disease, in this case palpation will help to identify pathological bony projections, to assess passive movement of the joint, and local tenderness;
- instrumental methods. Among which x-ray is done to everyone with any injury, to clarify the extent of the damage. Always images are captured in at least two perpendicular projections. This method helps to diagnose a dislocation, a crack, fracture and degree of displacement of bone fragments. As well as CT, MRI resorted to them for diagnosis in unclear picture on the radiograph. Also use them in case of multiple or combined trauma, habitual dislocation, when required operative treatment.
Should be differentiated from a fracture, in which there is abnormal mobility of the joint or an additional joint. In this situation, movement is will be absent.
The stages of treatment of an ankle injury
A dislocated ankle is a severe problem, because the future your ability to work depends on the effectiveness of assistance provided. Each stage of treatment in dislocation of the ankle joint includes certain actions that are required at this time. There are three main stages of treatment.
The first step. Emergency
Is in the first 48 hours. So, what to do when sprained ankle in the first minutes after injury:
- To ensure peace the limbs to eliminate any mechanical impact to remove your shoes.
- Applying cold will help reduce swelling and pain. Ice wrap with towel and apply for 15 minutes, then repeat the procedure every hour.
- Immobilize the limb to secure the limb in the position in which there is joint (to grab and knee joint). It is possible to use improvised means, for example line which will find application is functional tyres.
- To give an elevated position of the limb is due to the reduction of stagnation of blood in the vessels swelling of the limb will not grow.
Remember! It is impossible to straighten the joint — this may lead to a worsening of the condition, because you don’t know, maybe there’s a fracture!
The second stage. Long-term treatment
Treatment of sprained ankle in the second stage varies depending on severity.
- 1 degree. Reduction of the dislocation, the imposition vosmibratov bandage for 2-3 days.After removal of the dressing are assigned a hot compress, physiotherapy, physiotherapy.
- 2 the degree. Reduction of dislocation, the superposition of U-shaped plaster tape for 12 days, physiotherapy, massage and kinesitherapy (treatment time the bandage is removed). The rehabilitation period of 3 weeks.
- 3 degree. Reduction of the dislocation. When hemarthrosis — puncture is shown. Then the imposition of a plaster bandage for a period of 1 month (from the toes to the upper third of the leg). The introduction of novocaine in the joint area. The physiotherapy, massage and physical therapy. After removal of plaster is required to wear the pressure bandage for 1.5-2 months. And the total recovery time after a dislocated ankle can take up to three months
Thus, quickly heal a sprained ankle only when the first and second degrees of complexity of the injury.
Any injury requires the use of anesthetic ointments (Fastum gel, cream with bee venom) and anti-inflammatory drugs (ibuprofen).
Folk medicine — also assistant
- Alcohol compresses — dampen a cloth with alcohol, put on the injured limb, wrap in cellophane and put on socks (done at night).
- A solution of ½ tablespoon of salt + 125 ml of vinegar, wet the cloth and do as much as in the first case.
- Prepare an infusion of herbs: calendula, series, celandine and tansy. Flowers pour boiling water, steep for 40 minutes. Dampen the cloth and apply to the joint after drying, repeat the procedure.
- Compresses urine — dip the cloth in the urine, and repeat the procedure from the first paragraph.
Choose what and how to treat a sprained ankle needs attending. So every case of injury is strictly individual and is unique.
- remove the heels from the wardrobe;
- to strengthen the joints and muscles;
- to lose weight;
- to avoid careless movements;
- to protect the joints (elastic bandaging).