Best Practice Case Studies-Case 114 Asset 4 Foot and Ankle Dislocations

Video Transcription

Video Summary

The lecture was a broad overview of foot and ankle dislocations, focused on practical recognition and management for sports medicine fellows. Dr. Park emphasized the importance of not minimizing severe injuries on the sidelines and of checking neurovascular status, skin integrity, swelling, and possible compartment syndrome. He stressed that open injuries require urgent antibiotics, tetanus update, reduction, and surgical consultation.<br /><br />Key injuries discussed included ankle dislocations and fracture-dislocations, subtalar dislocations, Chopart joint dislocations, Lisfranc injuries, hallux MTP dislocations/turf toe, lesser MTP dislocations, and toe interphalangeal dislocations. He highlighted that ankle dislocations are rare without fracture but usually involve major ligament disruption and often need sedation, casting, and sometimes surgery. In fracture-dislocations, restoring syndesmotic anatomy is critical, and ankle arthroscopy is often useful in high-level athletes because articular cartilage injury is common.<br /><br />For Lisfranc injuries, Dr. Park reviewed exam findings such as plantar ecchymosis and midfoot tenderness, and noted that even subtle injuries should be treated cautiously with crutches, imaging, and early referral. He explained that these injuries often lead to arthritis and may require ORIF or arthrodesis depending on patient age, displacement, and athletic demands.<br /><br />Turf toe was presented as a significant plantar plate/sesamoid complex injury that may need MRI for diagnosis and surgery for severe instability or sesamoid migration. Lesser toe dislocations and IP dislocations are rare but can require reduction, pinning, or later fusion if chronic deformity develops.<br /><br />He closed by emphasizing team-based care, honest counseling about return-to-play expectations, and the psychological impact of these injuries on athletes.

Meta Tag

Edition 4th Edition

Related Case 4th Edition, Case 114

Topic Ankle

Keywords

4th Edition

4th Edition, Case 114

Ankle

foot and ankle dislocations

sports medicine

neurovascular assessment

open injuries

ankle fracture-dislocation

Lisfranc injury

turf toe

subtalar dislocation

reduction and immobilization

return-to-play counseling