Dislocation with an associated fracture of the ankle is a rare injury. A medial dislocation of the subtalar joint is uncommon, because the normal direction of the subtalar dislocation is lateral. This paper discusses a fracture medial dislocation of the ankle in a high school football player. Initial treatment of the injury included on-the-field management and referral to a hospital and an orthopedic surgeon. Rehabilitation of this injury was very slow and conservative in the initial stage after surgery. This included range of motion exercises for the ankle, full leg conditioning, and ice. After the fracture site was found stable the injury was treated much the same as a Grade II ankle sprain. The goal of rehabilitation was to return the range of motion, strength, and girth measurements of the affected side to those of the contralateral side as quickly as possible, so the athlete could resume athletics. When the affected side met these criteria, there was little to no pain with activity, and the orthopedic physician granted clearance, the athlete was allowed to return to competition.
Michael J. Carroll, Arie M. Rijke, and David H. Perrin
This study examined the effect of the Swede-O ankle brace on talar tilt in subjects with unstable ankle joints. Six college-age females with talar tilts greater than 9.5° at 15 decaNewtons (daN) of force on a Telos stress test device participated in the study. Each subject was X-rayed at five levels of force (0,6,9, 12, and 15 daN), first with a bare ankle then wearing a Swede-O ankle brace. A two-factor (Brace × Force) analysis of variance revealed a main effect for force, but no main effect for brace and no Brace × Force interaction. For the unbraced ankles, mean displacements were 8.2, 10.4, 11.9, and 13.1° at the four levels of force, respectively. After application of the brace, the talar tilts were 5.7, 8.5, 11.1, and 12.8°, respectively. These findings suggest that the Swede-O ankle brace was not effective in reducing talar tilt in subjects with unstable ankles. Any efficacy of the brace may be due to other factors, such as proprioceptive feedback during inversion.