son dislocated the ankle, some doubts

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hi

i allready found many informations on this site, also discussions in the forum, but some of them are old and can't be updated.

 so the question

my son is 14, he has always been a sedentary person, expecially i don't like the fact that started to gain weight. for this reason i was happy when decided to enter some outdoor activities.

then he called me and explained that he dislocated his ankle by falling on it and probably is broken. luckly one of our friends there is a doctor and could put it back in place.

i was explained that they went emergency only for a first evaluation, but every treatment will be at the clinic near home.

is the surgical treatment always necessary with dislocations? even if it has been reduced?  assuming the malleolis are broken are they usually fixed with surgery in kids?

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7 Replies

  • Posted

    After just spending over 2 months down with a broken ankle and understanding how much we take for granted the ability to walk normally, I would DEFINITELY recommend that you take your son to a good orthopedic specialist for an evaluation. Just because they are surgeons doesn’t mean they will automatically want to do surgery, but if that is what he needs, then better to do it now then face a lifetime of problems and pain in that ankle. 
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    • Posted

      Agreed far better to risk overdoing the care now. The ankle is such an important joint that it needs to be respected. Cheers Richard
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  • Posted

    Please take your son to a hospital now, or orthopedic doctor. Ankle injuries are so serious.
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  • Posted

    Hi DoNot,

    No, surgery is not always required with a displaced fracture.

    Any fracture, displaced or not, needs to receive proper care and treatment immediately. In most cases, this means protection and immobilization of the bone break to allow it to knit in place without being jarred or twisted out of place by weight and movement. This is usually done with a cast or CAM boot (aka air boot).

    Your son should have already been x-rayed to determine type and severity of any fractures he may have sustained.

    In my case I had bimalleolar ankle fractures that were displaced. My orthopedist was uncomfortable with displacement tolerances and suggested surgery to avoid danger of ankle arthritis later.

    Fortunately, I insisted on waiting to see how fractures healed. They healed beautifully without displacement.

    Please find your son a seasoned practitioner that hopefully will look at all options first before the word 'surgery' is even mentioned.

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    • Posted

      thanks for answers

      yes i'll go for the opinion of a specialist. i know if the treatment in child is different than in adult, i broke a wrist back in the day, but was a long time ago and don't remember anything useful.

      also i think it's important that the ankle heals well so that he won't be scared to play some sports in the future.

      my son was x-rayed and the break is very well aligned, but probably is unstable. he fractured the malleolis and a small bone in the foot. the leg has been splinted right after reduction so every movement during transport could be avoided.

      the doctor told that usually this kind of fractures need surgery, but the reduction is so good that we must try the conservative route. when the swelling reduces they will x-ray again and then cast if everything is ok. otherwise surgery will be necessary

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  • Posted

    ouch!

    conservative treatment isn't that unusual, i think my break is quite similar (tarsus and 2 malleolis) and the specialist suggested to try avoid surgery.

    immobilization is important, the emergency splint is often unconfortable due to the swelling but will be better once the cast is on.

    i had to be casted above knee but i'm sure younger bones heal faster.

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    • Posted

      thanks for answer, sorry to learn ankles can be injured so easily.

      yes my son still has the emergency cast on. it's a plaster wich has been made immediately and cut leghtwise to let space for the swelling, then closed with bandages before transport.

      at the emergency they wanted to remove it and put a plaster splint because probably this one can rub on the skin. but he was in bad pains.

      he is at home and the smallest movement causes disconfort, so i'm happy to learn the cast will be better, but i'm surprised to learn that the long one can be used for ankles!

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