What Is the Reduction of an Ankle Dislocation?

Reduction of ankle dislocation is surgery to re-set the ankle joint to heal properly. Sometimes a doctor can reposition the joint adequately without surgery, which is called a closed reduction.

An abnormal separation between the bones of a joint is called a dislocation. When this happens to the ankle joint, it is called an ankle dislocation. Ankle dislocations can happen to people of all ages. They occur with ankle fractures much more often than with just sprains.

The three bones that make up the ankle joint are:

• Tibia (shinbone)
• Fibula (the smaller bone in the leg)
• Talus (a bone in the foot)

The ankle joint helps the foot move up and down. Below this is another ankle joint called the subtalar joint. This joint is between the talus and another bone in the foot (calcaneus). This joint lets the foot move side to side. Normally, a set of very strong ligaments hold all of these bones tightly in place. The ligaments do not pull away or tear easily.

A severe injury can pull or tear these ligaments out of place, however. This creates an abnormal space between the bones. Ankle dislocations often occur along with a break in one or more of the ankle bones. In some cases, an ankle dislocation can happen without a break in the ankle bones. In these cases, the ankle dislocation occurs along with a severe ankle sprain. A severe sprain is when the ligaments are torn.

In most cases, the injury pushes the talus bone behind the other ankle bones. It may also be pushed to either side, to the front or upwards.

• An ankle dislocation is a relatively common type of dislocation encountered in the emergency department. They exist in two forms:
  • A true dislocation without fracture
  • A fracture-dislocation, occurring in the vast majority
• If the surgeon moves the bones back into place without surgery, it is called closed reduction.
• Sometimes, the surgeon may align the bones back in place through the surgery under general anesthesia to let them heal correctly. This is called reduction. 
• The surgeon may also use special plates and screws to keep the bones in place. This is called internal fixation. 
• During the same procedure, the surgeon usually fixes the torn ligaments to keep the bone in place.

• Usually, after the procedure, the patient will be monitored in the hospital. 
• Patients may be started on pain medications, antibiotics and blood thinners. 
• Patients might be advised to keep their ankle raised (elevated). 
• Usually, a cast or splint or boot is used to keep the ankle in position and reduce swelling. Usually, the recovery depends on the patient’s capability. 
• Most patients recover between six and eight months. 
• After the leg has healed a bit, the doctor may recommend physical therapy. These exercises will help the patient to restore and keep the range of motion and strength. 
• Some patients may need to use crutches or a cane for a few months after the injury. The doctor or physical therapist will let the patient know when they can go back to normal activities. 
• Doctors also recommend patients to eat a diet that is rich in calcium, vitamin D and protein that can help in bone healing.

Patients might have the following complications from ankle dislocations:

• Stiffness in joints (physical therapy may help)
• Ankle arthritis causing a lasting (severe) ankle pain
• Infection, which may need treatment with antibiotics or a follow-up surgery
• A broken bone that fails to heal correctly, which might need a follow-up surgery
• Pain from the plates and screws used in the surgery (these may be removed at a later date)
• Problems with wound healing
• Blood vessel or nerve damage from dislocations or fractures