Endgames Spot Diagnosis

An ankle that just didn’t look right

BMJ 2016; 355 doi: http://dx.doi.org/10.1136/bmj.i5056 (Published 10 November 2016) Cite this as: BMJ 2016;355:i5056
  1. Alistair R M Macey, specialty trainee 21,
  2. Charitra Grama, clinical observer1
  1. 1Department of Trauma and Orthopaedics, Hairmyres Hospital, Glasgow, UK
  2. Correspondence to: ARM Macey [email protected]

A 66 year old man fell down 14 steps and was subsequently unable to weight bear due to pain in the ankle. The foot was swollen and deformed, but radiographs showed no ankle fracture. Clinical findings and a radiograph that “just didn’t look right” prompted orthopaedic referral (fig 1). The patient was taken urgently to the operating theatre. What is the diagnosis?

Fig 1 Lateral radiograph of the left ankle

Answer

A fracture dislocation of the talus with disruption of the subtalar and talonavicular joints.

Discussion

Dislocation of …

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