NFL quarterback Robert Griffin III recently sustained an ankle dislocation, a very painful injury obvious to the millions watching on television as he lay on the field, writhing in pain.
Griffin appeared to have badly twisted his ankle when landing awkwardly on his left leg during a first-quarter rollout. It was a scary to watch the often-injured young star being carted off the field with an air cast on his ankle after suffering a non-contact injury.
Luckily he did not fracture his ankle, but instead dislocated it. His injury was defined as a disruption of the anatomical alignment of the ankle joint, which is often caused by an ankle fracture, or more rarely, complete ankle ligament tears.
How Does an Ankle Dislocation Occur?
An ankle dislocation occurs when a significant amount of force results in the bones in the ankle joint shifting and causing them to no longer be in proper alignment. This is rarely seen without any associated fracture. This is due to the fact that the ligaments that hold the ankle in joint are fairly strong compared to the bones that comprise the ankle joint.
How is an Ankle Dislocation Evaluated?
With any joint dislocation, the extremity is evaluated clinically for any neurovascular compromise. Radiographs, or x-rays, are taken to evaluate the bones and the degree of dislocation of the joint. Any associated fractures can also be evaluated through an x-ray. A CT-scan (3 dimensional x-ray) can help evaluate for bone fractures that may not have been seen with x-ray. An MRI can help evaluate ligamentous structures not seen on x-ray or CT scan.
How is an Ankle Dislocated Treated?
Ankle dislocations need to be relocated back into its joint. Early relocation of the joint is key, especially if there is neurovascular compromise to the foot. The ankle is then placed in a splint or cast, and immobilized for 6-8 weeks until the ligaments heal. If there is a bone fracture, surgery is often required to relocate the bones. The bones are fixated with screws and plates. If the ankle cannot be reduced back into anatomical alignment, surgery may be needed to realign the joint.
Prognosis of an Dislocated Ankle
The prognosis of an ankle dislocation depends on the amount of damage to the ankle. If there is any joint cartilage damage, it predisposes the ankle to development of arthritis. This reduces the chance of full recovery and mobility of the ankle. Ankle dislocations with associated fractures without any cartilage damage have a good prognosis if the bones are properly realigned and the ankle joint is placed back in anatomical position. Ankle dislocations without associated fractures are fairly unstable and require proper treatment in order to heal. There is a risk that without proper treatment that the ligaments heal in a lax position, causing ankle instability.
Prognosis of RGIII
RG III had an MRI after his injury, revealing no fracture in his ankle. A true ankle dislocation without any fracture is rare, so it is possible that he dislocated his subtalar joint, the joint below the ankle. This type of dislocation is more common than an ankle dislocation. Regardless, assuming there is no cartilage damage in the ankle or subtalar joint, and the joint is reduced properly, this is not a career threatening injury and he should have a full recovery once all the ligaments heal. I would anticipate this to take at least 6-8 weeks.
For an appointment with a doctor at one of our nine Southern California locations please call (877) 989-9110 or visit us at www.footankleinstitute.com.
He then went on to complete his surgical reconstruction fellowship with the University Foot and Ankle Institute, one of only a few fellowships recognized by the American College Foot and Ankle Surgeons.
Now playing an integral role at the University Foot and Ankle Institute, Dr. Yau’s treats various sports injuries, including sprains, arthritis and fractures. He also is passionate about helping diabetic patients avoid amputation through correction of deformities and wound healing.
Dr. Yau is available for consultation at our Simi Valley location.
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