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Ankle Dislocation
Julia R. Crim, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Diagnostic Checklist

            TERMINOLOGY

            • Definitions

              • Fracture-dislocation: Term used loosely for any ankle fracture with significant displacement of tibiotalar articulation
                • i.e., complete dislocation need not be present
              • Floating ankle
                • Ankle fracture-dislocation ₊ unstable injury to foot
              • Earle fragment (a.k.a. Volkmann fragment): Fracture of posterolateral corner of tibia
                • Due to avulsion of posterior inferior tibiofibular ligament
                • Volkmann fragment is misnomer but commonly used
              • Chaput-Tillaux fragment: Fracture of anterolateral corner of tibia
                • Due to avulsion of anterior inferior tibiofibular ligament
              • Bosworth fracture-dislocation (rare)
                • Proximal margin of fibular fracture fragment locked behind tibia

            IMAGING

            • General Features

              • Radiographic Findings

                • CT Findings

                  • MR Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Staging, Grading, & Classification

                            CLINICAL ISSUES

                            • Presentation

                              • Natural History & Prognosis

                                • Treatment

                                  DIAGNOSTIC CHECKLIST

                                  • Consider

                                    Selected References

                                    1. Crim J et al: CT assessment of the prevalence of retinacular injuries associated with hindfoot fractures. Skeletal Radiol. 42(4):487-92, 2013
                                    2. Lazarettos I et al: Open ankle dislocation without associated malleolar fracture. J Foot Ankle Surg. 52(4):508-12, 2013
                                    3. Herscovici D Jr et al: Management of high-energy foot and ankle injuries in the geriatric population. Geriatr Orthop Surg Rehabil. 3(1):33-44, 2012
                                    4. Schepers T et al: An irreducible ankle fracture dislocation: the Bosworth injury. J Foot Ankle Surg. 51(4):501-3, 2012
                                    5. Gogi N et al: Anterior dislocation of the tibio-talar joint without diastasis or fracture--a case report. Foot Ankle Surg. 14(1):47-9, 2008
                                    6. Mulligan ME: Ankle and foot trauma. Semin Musculoskelet Radiol. 4(2):241-53, 2000
                                    7. Bos M et al: Acute disruption of the posterior tibial tendon associated with open-fracture dislocation of the ankle. Foot Ankle Int. 18(12):823-6, 1997
                                    8. Wroble RR et al: Ankle dislocation without fracture. Foot Ankle. 9(2):64-74, 1988
                                    Related Anatomy
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                                    Related Differential Diagnoses
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                                    References
                                    Tables

                                    Tables

                                    KEY FACTS

                                    • Terminology

                                      • Imaging

                                        • Top Differential Diagnoses

                                          • Pathology

                                            • Diagnostic Checklist

                                              TERMINOLOGY

                                              • Definitions

                                                • Fracture-dislocation: Term used loosely for any ankle fracture with significant displacement of tibiotalar articulation
                                                  • i.e., complete dislocation need not be present
                                                • Floating ankle
                                                  • Ankle fracture-dislocation ₊ unstable injury to foot
                                                • Earle fragment (a.k.a. Volkmann fragment): Fracture of posterolateral corner of tibia
                                                  • Due to avulsion of posterior inferior tibiofibular ligament
                                                  • Volkmann fragment is misnomer but commonly used
                                                • Chaput-Tillaux fragment: Fracture of anterolateral corner of tibia
                                                  • Due to avulsion of anterior inferior tibiofibular ligament
                                                • Bosworth fracture-dislocation (rare)
                                                  • Proximal margin of fibular fracture fragment locked behind tibia

                                              IMAGING

                                              • General Features

                                                • Radiographic Findings

                                                  • CT Findings

                                                    • MR Findings

                                                      • Imaging Recommendations

                                                        DIFFERENTIAL DIAGNOSIS

                                                          PATHOLOGY

                                                          • General Features

                                                            • Staging, Grading, & Classification

                                                              CLINICAL ISSUES

                                                              • Presentation

                                                                • Natural History & Prognosis

                                                                  • Treatment

                                                                    DIAGNOSTIC CHECKLIST

                                                                    • Consider

                                                                      Selected References

                                                                      1. Crim J et al: CT assessment of the prevalence of retinacular injuries associated with hindfoot fractures. Skeletal Radiol. 42(4):487-92, 2013
                                                                      2. Lazarettos I et al: Open ankle dislocation without associated malleolar fracture. J Foot Ankle Surg. 52(4):508-12, 2013
                                                                      3. Herscovici D Jr et al: Management of high-energy foot and ankle injuries in the geriatric population. Geriatr Orthop Surg Rehabil. 3(1):33-44, 2012
                                                                      4. Schepers T et al: An irreducible ankle fracture dislocation: the Bosworth injury. J Foot Ankle Surg. 51(4):501-3, 2012
                                                                      5. Gogi N et al: Anterior dislocation of the tibio-talar joint without diastasis or fracture--a case report. Foot Ankle Surg. 14(1):47-9, 2008
                                                                      6. Mulligan ME: Ankle and foot trauma. Semin Musculoskelet Radiol. 4(2):241-53, 2000
                                                                      7. Bos M et al: Acute disruption of the posterior tibial tendon associated with open-fracture dislocation of the ankle. Foot Ankle Int. 18(12):823-6, 1997
                                                                      8. Wroble RR et al: Ankle dislocation without fracture. Foot Ankle. 9(2):64-74, 1988