Foot and ankle dislocation
Among foot dislocations are distinguished:
- shin-talar joint dislocation
- Isolated dislocation of the talus (talar bone)
- subtalar foot dislocation
Dislocation of the shin-talar joint divided into front and rear (the most common) and side. In pure form all dislocations goleno-talar joint are rare. More often sprains goleno-talar joint is a result of the fracture of the ankle and especially the often complicated fracture of the tibia on the type of Dupuytren. Anterior dislocation of the joint tarainogo goleno-generated forced dorsiflexion of the foot, gives a significant lengthening of the rear of the foot and reduction of the calcaneal posterior projection. In pure dislocation of the foot back, going on a sharp plantar flexion, there are, on the contrary, the lengthening and shortening of the rear heel of the foot.
Lateral foot dislocation
Lateral foot dislocation without fracture of the ankle unthinkable. Very often the lateral dislocations of the foot gives Dupuytren fracture. At this stop position becomes inwardly or outwardly. Reduction of net dislocations of the foot is very easy to manage, especially under anesthesia.
Talus (talar bone) dislocation
Isolated dislocation of the in its pure form is rare. Talus can be moved in all directions (but more outward), and even to turn around the axis. To get this dislocation, it is necessary to break the ligaments that secure it to the lower leg to the heel and navicular bones. These gaps occur or forced inward rotation (pronation) or outward (supination) or at the rear or concomitant plantar flexion of the foot. The prevailing direction of the force determines the displacement of the talus in one way or another. Part of the neck of the talus with the breaks. Reduction of net dislocations of the talus is possible with traction foot in a flexed knee and with the direct pressure on the protruding bone. In difficult cases, resorted to the bloody installation dislocated talus in place, or even to remove it.
Subtalar dislocation turns inwards and outwards with a strong inward rotation (pronation) or outward (supination), fixed on the ground forefoot. In this regard, the joints are torn talocalcaneal and Tara-scaphoid. A sharper separation occurs in the collision-navicular joint. With a sharp inward rotation (pronation) fixed forefoot rotational movement of the lower leg turns inward shift of the navicular bone of the forefoot outwards. Under the zheusloviyah sharp twisting outward of the foot with a rotation (rotation) gives the tibia outward displacement of the navicular bone and the foot inside. Recognize subtalar dislocation inwards easily identified by this characteristic position of the foot. The ankle joint is possible to produce with the flexion and extension.
The procedure for reduction of the foot dislocation.
Extremely rare forms of subtalar dislocation backward or forward to its origin require fractures.
Reduction of pure subtalar dislocations under anesthesia easy to succeed in mind the vastness of articular fractures of the foot joints. Fixing the immobilizing bandage for 4-5 weeks, and approximately the same amount of time, rehabilitation and physiotherapy - restore the normal function of the foot almost in 2-3 months.
Rare types of foot bones dislocations
From rare types of foot bones dislocations should be noted:
- dislocated in the rear of one of the navicular, one cuboid, one, two or three sphenoid bones
- very rare dislocations of the Chopard junction
- somewhat more frequent dislocations of metatarsal bones (metatarsi) in the Lisfranc (midfoot) joint - most of all bones in the rear and the outside (total dislocation), at least - one or more bones (partial dislocation)
There are these rare dislocations of of foot bones from the effects of large forces, such as a fall from a height-to-toe in the presence of a sharp plantar flexion or direct pressure on the forefoot with plantar flexion. More often than dislocations of in Lisfranc junction obtained fractures and distortion.
Without X-ray to establish an accurate diagnosis of these injuries is difficult. Reduction of these dislocations manages traction beyond the end of the foot bone protruding backpressure. The cast captures the foot for 4-5 weeks. In it a week later the patient can walk.
Quite often, these dislocations of of the foot bones are combined with bone fractures and detachments on the attachment of powerful ligaments and tendons, nerve damage and soft tissue. In such cases, recovery of function of the foot is very slow, sometimes for years kept the pain, forcing resort to surgery: excision of small bone fragments, or resection of the neuromas neurotomy. But before you operate, you need to test the effect of insoles made exactly plaster cast with a sore foot.
Dislocations of metatarsus-phalanx and interphalangeal joints of the foot occurs as well as on the hands.