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Ankle Dislocation
Julia R. Crim, MD; Corrie M. Yablon, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Definitions

                • Fracture-dislocation: any ankle fracture with significant displacement of tibiotalar joint
                  • Complete dislocation need not be present
                • Floating ankle (seldom used term)
                  • Intact ankle mortise with fractures above and below ankle joint
                • 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 fibula 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. Wight L et al: Pure ankle dislocation: a systematic review of the literature and estimation of incidence. Injury. 48(10):2027-34, 2017
                                      2. Crim J et al: CT assessment of the prevalence of retinacular injuries associated with hindfoot fractures. Skeletal Radiol. 42(4):487-92, 2013
                                      3. Lazarettos I et al: Open ankle dislocation without associated malleolar fracture. J Foot Ankle Surg. 52(4):508-12, 2013
                                      4. 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
                                      5. Schepers T et al: An irreducible ankle fracture dislocation: the Bosworth injury. J Foot Ankle Surg. 51(4):501-3, 2012
                                      6. 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
                                      7. Mulligan ME: Ankle and foot trauma. Semin Musculoskelet Radiol. 4(2):241-53, 2000
                                      8. 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
                                      9. 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

                                              • Clinical Issues

                                                • Diagnostic Checklist

                                                  TERMINOLOGY

                                                  • Definitions

                                                    • Fracture-dislocation: any ankle fracture with significant displacement of tibiotalar joint
                                                      • Complete dislocation need not be present
                                                    • Floating ankle (seldom used term)
                                                      • Intact ankle mortise with fractures above and below ankle joint
                                                    • 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 fibula 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. Wight L et al: Pure ankle dislocation: a systematic review of the literature and estimation of incidence. Injury. 48(10):2027-34, 2017
                                                                          2. Crim J et al: CT assessment of the prevalence of retinacular injuries associated with hindfoot fractures. Skeletal Radiol. 42(4):487-92, 2013
                                                                          3. Lazarettos I et al: Open ankle dislocation without associated malleolar fracture. J Foot Ankle Surg. 52(4):508-12, 2013
                                                                          4. 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
                                                                          5. Schepers T et al: An irreducible ankle fracture dislocation: the Bosworth injury. J Foot Ankle Surg. 51(4):501-3, 2012
                                                                          6. 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
                                                                          7. Mulligan ME: Ankle and foot trauma. Semin Musculoskelet Radiol. 4(2):241-53, 2000
                                                                          8. 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
                                                                          9. Wroble RR et al: Ankle dislocation without fracture. Foot Ankle. 9(2):64-74, 1988