Open Ankle Dislocation Without Fracture With Neurovascular Bundle Entrapment Confirmed Preoperatively by CT...

Area of Science:

• Orthopedic Surgery
• Radiology
• Trauma Care

Background:

• Open pure ankle dislocations without associated fractures are uncommon.
• Syndesmotic diastasis can lead to entrapment of vital structures.
• Neurovascular compromise is a significant concern in severe ankle injuries.

Purpose of the Study:

• To report a case of open pure ankle dislocation with deep entrapment.
• To highlight the utility of computed tomographic angiography (CTA) in diagnosis and surgical planning.
• To emphasize the importance of early recognition and intervention for irreducible dislocations.

Main Methods:

• A case report of a 61-year-old male following a blunt thigh trauma.
• Preoperative computed tomographic angiography (CTA) to assess entrapped structures.
• Open reduction with careful disengagement of entrapped tendons and neurovascular bundle.
• Staged dynamic fixation of the tibiofibular syndesmosis.

Main Results:

• Successful open reduction and syndesmotic fixation were achieved.
• The patient recovered fully with no pain or range of motion limitation.
• CTA accurately identified entrapment of posterior tibial, flexor digitorum longus, and flexor hallucis longus tendons with the tibial neurovascular bundle.

Conclusions:

• Deep entrapment of neurovascular structures should be suspected in irreducible ankle dislocations.
• Early CTA is crucial for surgical planning in such cases.
• Prompt surgical intervention can lead to excellent outcomes in complex ankle injuries.