Description of patient (type of occupation, indication of age, intensity of sport):
The patient was placed in an above-the-knee plast after surgery. Three hours post-operative at the x-ray examination, the implant was dislocated.
History and previous treatment:
Ankle osteoarthritis treated with the Zimmer total ankle arthroplasty.
Current complaints:
Post-operative dislocation of ankle arthroplasty.
Physical examination:
Dislocation of ankle arthroplasty.
Radiology:
X-ray:
[Picture 1]
Dislocation of ankle arthroplasty with a medial malleolar fracture.
Images:
Case summary:
Post-operative dislocation of ankle arthroplasty.
Question(s) to this case:
how the dislocation can be managed? Closed reduction? Open reduction, malleolar fixation? external fixation?
Expert:
Direct reposition in order to avoid neurovascular complications! Treatment by means of fixation of medial malleolar fracture. Check if the posterior structures are still intact: FHL and PTT. If they are ruptured then reconstruct. If the reposition cannot easily be obtained then check for interposition.
If the reposition cannot be maintained then apply an external fixator.
The treatment and the postoperative X - Ray after reconstruction has not been received yet.