Foot dislocation and distortion are two sides of the same coin when it comes to injuries to the ligaments, bones and joint capsule of the ankle . Let's first take a closer look at foot dislocation . The term dislocation refers to a dislocation. This means that the bones change their natural position - the joint surfaces shift in relation to each other. A foot dislocation can occur in the upper ankle joint (OSG) or the lower ankle joint (USG), but also in both parts of the ankle joint at the same time.
A sprain, colloquially known as a sprain or strain, primarily affects the ligaments, which are solid strands of collagen fibers that connect the bones together. Their task is to stabilize the ankle joint. A sprain occurs most frequently in the upper ankle joint (OSG). The injury is usually caused by a twisting of the joint or a sudden twisting of the foot. This severely overstretches the ligaments. Depending on the severity of the sprain, individual or numerous tissue fibers tear. In the case of a sprain , the joint capsule is often also affected.
The ankle joint and the bones of the foot © bilderzwerg / Fotolia
The cause of a foot dislocation is usually a sudden jerky force on the ankle joint that the ligaments and tendons are unable to absorb. Depending on the intensity of the force applied, ligaments, nerves and tendons are often also affected. Sometimes a dislocation can even lead to torn ligaments in the ankle joint or tears in the joint capsule.
Dislocations and sprains of the foot cause similar symptoms, although dislocations generally cause much more pronounced symptoms. Both the drifting apart of the bones in a dislocation and the overstretching of the ligaments in a sprain cause severe pain.
With both injuries, the ankle joint can only be moved with pain and swells considerably immediately after the trauma. In most cases, small blood vessels on and in the joint are also injured. This usually causes a bruise to develop. In the event of a dislocation, the joint may also appear deformed and the bones of the joint may no longer be in their normal position.
Ligaments of the ankle joint © bilderzwerg / Fotolia
It is advisable to cool the ankle as soon as possible after the trauma. This measure keeps the swelling in check, which is important for treatment. The less swelling there is, the easier it will be to reposition the ankle in the event of a dislocation.
Also immobilize the ankle with a compression bandage and elevate the foot. If the symptoms persist or increase, you should see a doctor. This is best done by a specialist in joint injuries, usually a trauma surgeon or orthopaedic surgeon. They can carry out further examinations to determine whether there is a dislocation, sprain or even a torn ligament or broken bone.
Symptoms of a sprained or dislocated foot © Leo / Fotolia
In order to make a diagnosis, the mobility of the joint is first checked and palpated. As this can be extremely painful immediately after the accident, these examinations are usually carried out under appropriate pain medication.
In the next step, imaging procedures such as X-rays or ultrasound(sonography) are used. Ultrasound can be used to assess the soft tissue structures of the joint, in particular the ligament structures, cartilage and capsule. X-rays can be used to examine the bone in more detail. This is important if there is suspicion of damage to the bone in the form of a fracture.
More rarely, a computer tomography(CT) or magnetic resonance imaging(MRI) scan is also necessary in order to adequately visualize the injuries. However, as CT involves significant radiation exposure and most ankle and foot injuries can be diagnosed using ultrasound and X-rays, tomographic imaging using CT and MRI is rarely performed and only before a planned surgical procedure.
In the case of a dislocation, the joint bones must be brought back into their original position. This can sometimes be achieved simply by pulling on the ends of the bones and applying pressure. In such cases, the bones spring back into their original position in the joint. However, this process is sometimes very painful and must be carried out with painkillers or under a short anesthetic or local anesthetic.
The medical term for this adjustment of the joint is reduction and is usually carried out under X-ray control. In any case, an X-ray check should be carried out after reduction to ensure that the bone ends are in their correct position and that no fractures have occurred.
The subsequent treatment steps are similar for dislocations and sprains. The ankle joint is usually immobilized with a splint or plaster cast. Furthermore, the regular use of painkillers is generally recommended, especially in the early stages. In particular, painkillers that also cause the tissue to shrink (e.g. Diclofenac = Voltaren®) are often used very successfully.
After 8 to 10 days, the foot should be slowly mobilized with special exercises so that the mobility of the joint is maintained. In the case of a sprain with severe overstretching of the ligaments, but also after a dislocation, it is necessary to relieve the foot for a longer period of time. It can take up to 5 months for the stretched ligaments to completely heal and for the joint to regain its full stability.
Surgical treatment can be particularly useful for young people who want to continue doing a lot of sport in the future. This involves tightening the ligaments and capsule apparatus in order to prevent future dislocations and sprains. Otherwise, they could lead to permanent instability of the ankle joint. Repeated dislocations and sprains also promote premature wear and tear of the ankle - resulting in ankle arthrosis. Surgery is unavoidable if ligaments are torn or vessels and nerves are injured.
The prognosis for ankle sprains and dislocations is generally good, but there may still be a permanent restriction of mobility, pain and sometimes sensitivity to the weather. Dislocations and sprains of the foot should not be underestimated. A harmless twisted ankle often becomes a permanent problem if not treated properly. This is why dislocations and sprains should be treated by an orthopaedic specialist.
As ankle injuries most frequently occur during sport, they can temporarily or permanently restrict the athlete's career and sporting activity. Therefore, the prevention of these sports injuries is of particular importance, which is practiced through appropriate supports and stabilizing footwear in specific sports. Prevention is always better than treatment!
Sports that involve fast running movements in particular put a lot of strain on our ankles. It is essential to warm up sufficiently before doing sport in order to minimize the risk of injury. This applies all the more as we get older. The wear and tear of ligaments and tendons, osteoarthritis and increasing muscle loss increase the risk of injury.
