Managing ankle fracture-dislocation injury in the emergency department: a case study

Ankle fracture-dislocation is a serious injury that requires prompt and appropriate management. The proximity of various neurovascular structures around the ankle joint means there is a risk of nerve or blood vessel damage. Initial management in the emergency department (ED), therefore, includes the realignment and repositioning of the dislocated joint to its normal anatomical position, referred to as reduction. This article details a case study of a 42-year-old woman who presented to an ED in Ireland with a suspected ankle fracture-dislocation following a fall while playing sport. Following triage and initial pain management, the patient's care was managed by an advanced nurse practitioner, in collaboration with medical colleagues, which involved history taking and physical assessment, reduction of the dislocation and splinting of the ankle under procedural sedation, monitoring during and after procedural sedation, and radiological imaging.