Abstract:
An ankle dislocation without an accompanying fracture is extremely rare, and an open ankle dislocation is even rarer. Due to its rarity, there is no consensus on the optimal treatment strategy. A professional basketball player (a 28-year-old male) incurred an open ankle dislocation (with no accompanying fracture) during a basketball game due to plantar flexion and inversion of his ankle during the transition from dashing to stop motion. The same day, an emergency reduction under spinal anesthesia was performed with primary closure of the wound. Considering the complications of infection and decreased ankle range of motion (ROM), primary ligament repair was not performed. He was treated conservatively with cast immobilization for four weeks, and early weight-bearing and ROM exercises were initiated. At six weeks postoperatively, stress radiography did not reveal ankle instability. After three months of conservative treatment, the patient was able to play basketball at his previous performance level. Four weeks of cast immobilization without ligament repair plus early rehabilitation with weight-bearing and ROM exercises allowed for an early return without complications. Even in high-level athletes, open ankle dislocation without an accompanying fracture can be treated adequately with conservative therapy.
摘要:
没有伴随骨折的踝关节脱位极为罕见,开放性踝关节脱位更罕见。由于它的稀有性,关于最佳治疗策略尚无共识。一名职业篮球运动员(一名28岁的男性)在篮球比赛中由于足底屈曲和脚踝倒置而发生了开放性踝关节脱位(没有伴随骨折)。同一天,在脊髓麻醉下进行紧急复位,并初次闭合伤口。考虑到感染和踝关节活动范围(ROM)下降的并发症,未进行原发性韧带修复.他保守地接受了四周的石膏固定治疗,并开始早期负重和ROM练习。术后6周,应力射线照相术未显示踝关节不稳定。经过三个月的保守治疗,患者能够以他以前的表现水平打篮球。在没有韧带修复的情况下进行为期四周的石膏固定,再加上负重和ROM锻炼的早期康复,可以早日恢复而没有并发症。即使在高水平运动员中,没有伴随骨折的开放性踝关节脱位可以通过保守治疗得到充分治疗。