ABSTRACT
CONTENTS I. Introduction ...................................................................................................................... 196 II. Ankle Dislocation.............................................................................................................. 196
A. Historical Review....................................................................................................... 196
B. Epidemiology and Anatomy...................................................................................... 197
C. Pathogenesis and History .......................................................................................... 197
D. Clinical Findings........................................................................................................ 197
E. Radiographic Findings .............................................................................................. 198
F. Treatment Options..................................................................................................... 199
G. Prognosis and Long-Term Follow-Up....................................................................... 199 III. Subtalar Joint Dislocation................................................................................................. 199
A. Historical Review....................................................................................................... 199
B. Epidemiology and Anatomy...................................................................................... 200
C. Pathogenesis and History .......................................................................................... 200
D. Clinical Findings........................................................................................................ 200
E. Radiographic Findings .............................................................................................. 200
F. Treatment Options..................................................................................................... 201
G. Long-Term Results and Prognosis............................................................................. 203 IV. Great Toe MTP Dislocation ............................................................................................. 203
A. Historical Review....................................................................................................... 203
B. Epidemiology and Anatomy...................................................................................... 203
C. Pathogenesis and History .......................................................................................... 203
D. Clinical Findings........................................................................................................ 204
E. Radiographic Findings .............................................................................................. 205
F. Treatment Options..................................................................................................... 205
G. Prognosis and Long-Term Outcome.......................................................................... 207 V. Conclusion ........................................................................................................................ 207 References .................................................................................................................................. 208
I. INTRODUCTION
Dislocationsof the ankle, subtalar, andgreat toemetatarsal-phalangeal (MTP) jointsarenot common but can result in significant long-term disability if not recognized and reduced expediently and treated properly. Dislocation of these joints involves forceful energy and results in severe soft tissue injury. Open dislocation can occur at all three of these joints andmust be treated on an emergency basis with surgical lavage and repeated debridements as indicated. Closed dislocations also require emergency reduction, but can often be accomplished in an outpatient setting such as an emergency room. Stiffness, joint debri (Figure 8.1), and resultant arthrosis can all accompany ankle and subtalar dislocations. Stiffness can also accompany MTP dislocations of the great toe, but disruption of the plantar plate, retraction of the sesamoid complex, and chronic pain are the most common sequelae.
