Dislocation of the foot( ankle, ankle joint) - Causes, symptoms and treatment. MF.

In recent decades, the lifestyle of most people is becoming less and less mobile: a working day is spent in the office, and free time is devoted to sitting near a computer, TV, or just lying on the couch. Due to this, muscle tone decreases, the strength and elasticity of ligaments decreases, and as a consequence, there is an increased risk of injury. Especially often doctors face traumatic injuries of the ankle, with the movement of the person holding the entire mass of the body. The most common trauma of the ankle( foot) is a dislocation.

Dislocation of the ankle is a violation of the normal position of the bones forming this joint - peroneal, tibial and talant, which is accompanied by partial damage or complete rupture of ligaments.

Causes of ankle dislocation

The main cause of ankle dislocation is increased load on the foot if its position is incorrect. Damage to the ankle is often found among athletes, as well as in ordinary people: when falling, striking, tucking in feet, wearing uncomfortable shoes.

Symptoms of ankle dislocation

The level of ligament damage determines three severity of ankle injury, each of which is characterized by certain symptoms:

- The first degree of is characterized by the rupture of individual fibers that appear in the ligament, manifested with mild swelling, tenderness in exercise, walking andpalpation. There is a slight swelling of the joint. Despite the painful sensations, the motor functions are preserved.
- For the of the second degree , a partial ligament rupture is typical, in which the edema spreads to the entire upper part of the foot, the person experiences severe pain not only when walking, but also at rest. When walking, the patient experiences pronounced discomfort and painful sensations.
- The third degree of dislocation of is determined by complete rupture of the joint ligament. In this case, edema and hemorrhage spread to the surface of the foot and the sole, with palpation and load on the foot there is a sharp pain, walking is impossible.

Appearance of the leg with ankle dislocation of the third degree

First aid for suspected dislocation of the foot

In case of an ankle injury, the first aid should be given to the victim immediately, before calling a doctor. The speed of rendering the patient with pre-hospital care depends on the length of the rehabilitation period, as well as the degree of recovery of the normal motor activity of the ankle.

As first aid, the following manipulations are necessary: ​​

- maximum immobilization of the damaged foot with the help of an elastic bandage;
- the leg should be placed on a raised solid surface: increased blood outflow reduces the development of edema;
- attach ice to the injury site, which will reduce swelling and painful sensations - the bottle filled with ice or cold water is wrapped with a towel to prevent excessive hypothermia of the joint and is applied to the injury site for 10 minutes every half hour;
- if necessary, give the patient an anesthetic;
- immediately deliver the patient to a medical facility.

In cases of ankle injury, it is strictly forbidden:

- try to fix the dislocation independently, as this can lead to rupture of the ligament and fracture of the bone;
- if the injury occurred in the winter, you can not remove the shoes from the victim, as this can significantly worsen his condition.

Diagnostic of dislocation of the foot

Dislocation of the ankle has similar symptoms and can be confused with such injuries as ankle sprain, bruise and fracture of the foot bones. Precisely diagnose the injury and determine the severity of it can only the doctor with the help of procedures such as:

- a detailed interview of the victim;
- palpation of the joint;
- radiography;
- in severe cases, an MRI or CT scan of the affected area.

X-ray image of ankle dislocation

Treatment of dislocation of the foot

Treatment of ankle dislocation depends on the severity of the injury and the presence of the associated comorbidities.

Treatment of ankle dislocation of the first degree

1. Cryotherapy - the effect of cold on the damaged area. Achieved by applying to the injured place cooling hypothermic packages that can be purchased at the pharmacy, or a normal bottle filled with ice or snow. This procedure is most effective in the first hours after the injury.
2. Immobilization of the damaged joint with the help of bandage of elastic bandage or orthosis. In the absence of special tools for temporary dressing, you can use a regular bandage, fabric, scarf, etc. When applying the dressing, you must ensure that the foot is fixed at a right angle, and the dressing itself is sufficiently free to ensure normal blood circulation.
3. Providing complete rest for the of the damaged foot.
4. After the patient ceases to experience acute pain, which usually occurs after 2-3 days, it is recommended to apply warming compresses, iodine mesh, lubrication with warming ointments, massage and warm baths. The paraffin application also has a positive effect.

In some cases, the patient is prescribed pain medications, as well as physiotherapeutic procedures that significantly accelerate the process of tissue repair.

Removal of the fixing foot of the dressing is allowed only after even the most minor loads stop causing the patient pain, but in any case not earlier than two weeks after the injury.

In the treatment of dislocation of the ankle of the first degree, some methods of traditional medicine are effective:
- Prepare an infusion of string, celandine, tansy and calendula flowers, which in the form of a compress is applied to the injured place.
- Prepare a mixture of half a glass of 9% vinegar and half a tablespoon of rock salt. Moistened with this solution, the napkin is applied to the damaged area, which helps to remove the swelling and reduce pain.

Treatment of ankle dislocation of the second degree

Treatment is slightly different from the treatment of an ankle injury of an easier degree. The foot is fixed not by an elastic bandage, but by the application of a U-shaped plaster ganglion. The cast is removed after about ten to twelve days, during which the patient is warmed physiotherapy, massage and exercise therapy. When carrying out such procedures, the langet is removed.

Along with this, a course of non-steroidal anti-inflammatory drugs such as ibuprofen, nimesulide, ketorolac, etc., which helps to reduce and eliminate swelling and inflammation symptoms, is also indicated. It also shows the use of analgesics in the form of tablets and injections. In the case of significant damage to the cartilaginous tissue, oral chondroprotectors are prescribed, which stimulate the synthesis of chondroitin and regenerate tissues damaged in trauma.

After the plaster langet is removed, a long course of therapeutic physical training is carried out, which contributes to restoring the motor activity of the injured ankle. Also, external application of the ointment belonging to the class of chondroprotectors is prescribed, the recovery effect of which significantly reduces the duration of the rehabilitation period.

As a rule, recovery occurs in three weeks.

Treatment of ankle dislocation of the third degree

In the diagnosis of dislocation of the ankle joint of the third degree, compulsory hospitalization of the patient is indicated. An operation is performed, during which the structure of the ruptured ligaments and, if necessary, the joint, is restored. Damaged fabrics are sealed with stitches or staples, after which a circular plaster cast is applied to the area from the fingertips to the upper leg. The cast is removed after about three weeks, after complete healing of the tissues.

After removing the gypsum, a flexible bandage is applied to the foot of the patient and a set of procedures for physiotherapy, therapeutic massage and physical education is carried out. The final stage of rehabilitation of the patient can be carried out at home, and for the speedy recovery and recovery of normal motor activity, he must carefully follow all the recommendations of the doctor and regularly do individually selected exercises. In case of proper treatment, recovery occurs about a month later.

When diagnosing an ankle sprain of the second and third degree, the joint should only be guided by an experienced physician, and it is advisable to perform this operation within two hours after the injury. An ankle is guided under local anesthesia( novocain).

Physiotherapy and physiotherapy for rehabilitation after dislocation of foot

In the treatment of ankle dislocation, physiotherapy and physiotherapy play a big role. Carrying out a course of physiotherapy helps to reduce and relieve inflammation, swelling and soreness with loads and movement. Most often the patient is given electrophoresis with a solution of potassium iodide, UHF, and in some cases - novocaine or lidocaine blockade of the injured joint. Performing a complex of therapeutic exercises significantly reduces the recovery period after injury.

Physiotherapy exercises have the following positive effects:

- develops the mobility of the damaged joint, helps prevent future disruptions to the normal functioning of the joint;
- activates blood circulation in the joint, prevents muscle atrophy;
- significantly reduces the harm of prolonged compliance with bed rest;
- has a dosed load on the joint, as a result of which the pain sensations are greatly reduced;
- increases the overall tone and fitness of the patient.

Therapeutic gymnastics consists of a series of light exercises of rotation, flexion and extension of the foot.
- Simultaneous and alternating bending and unbending of the fingers of a sick and healthy foot, alternating and simultaneous rotation of the patient and healthy feet, turning the foot outward and inward. Each exercise is repeated 20-30 times at a different pace.
- Sock of one leg is placed on the toe of the second. The foot bends and unbends, overcoming the resistance exerted by the other leg. Exercise is done 15 to 20 times at a slow pace.
- In the sitting position, try to grab small balls, a pencil, etc. with your toes.
- In the standing position, put your hands on your waist, slowly climb on your toes, and then fall on the entire foot. The exercise is performed 30 times.

In addition, a positive effect is observed from the so-called passive gymnastics, when the patient, while maintaining the immobility of the foot, strains the muscles in the injured area. Regular exercise of such exercises improves blood circulation and maintains muscle tone, preventing muscle atrophy.

Prevention of dislocation of the foot

The main measures to prevent ankle dislocation is a properly selected diet, including calcium-rich and vitamin-rich foods and regular exercise. Also, you should carefully consider the choice of comfortable shoes.

Rev.doctor of traumatologist-orthopedist Savchenko V.R.