Ankle Dislocation (Child)
Ankle dislocation is when a strong force pushes an ankle bone out of place. To treat this, the bone is moved back into place. This is called reducing the dislocation.
Ankle dislocations cause pain and swelling. Sometimes the ankle looks blue, purple, or gray (discolored). The area will look deformed. Ankle dislocations often occur with sprains and sometimes with fractures.
A dislocation must be put back into place as soon as possible. A bone that is out of place for too long may cause long-lasting joint, nerve, or blood vessel damage. IV (intravenous) pain medicines are often given before a reduction. In most cases, bones go back into place easily. In other cases, surgery is needed. An X-ray may be done after reduction to see how the joint looks.
A child with a joint dislocation will likely be sent to a bone doctor (orthopedist) for evaluation and follow-up.
Based on how severe the injury is, the ankle may be held in place with a stabilizer. This limits joint motion so the ankle can heal. The healthcare provider will decide which type of stabilizer to use. It will be a cast, bandage, splint, or boot.
Your child will likely also be given crutches to keep weight off the injured ankle.
Home care
Medicine
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The healthcare provider may prescribe medicines for pain and swelling. Or your child may use over-the-counter medicine as directed by the provider. Follow the provider’s instructions when giving these medicines to your child.
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Always talk with your child's provider before giving these medicines if your child has long-term (chronic) liver or kidney disease, or has ever had a stomach ulcer or gastrointestinal bleeding.
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Don’t give your child ibuprofen if they are younger than 6 months old.
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Don’t give your child aspirin.
General Care
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Have your child rest. Your child shouldn't walk or bear weight on the injured ankle until the provider says they can do so.
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Place an ice pack over the injured area for no more than 20 minutes. Do this every 3 to 6 hours for the first 24 to 48 hours. Keep using ice packs 3 to 4 times a day for the next 2 days. Then use as needed to ease pain and swelling. To make an ice pack, put ice cubes in a plastic bag that seals at the top. Wrap the bag in a clean, thin towel or cloth. Never put ice or an ice pack directly on the skin. The ice pack can be put on the cast, bandage, or splint. As the ice melts, be careful that the cast, bandage, or splint doesn’t get wet.
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If your child has a boot, open it to apply an ice pack, unless told otherwise by the provider. Wrap the ice pack in a clean, thin towel or cloth. Never put ice or an ice pack directly on the skin.
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Keep the cast, bandage, splint, or boot dry. When bathing, protect it with 2 large plastic bags. Place 1 bag around the other. Tape each bag with tape at the top end or use rubber bands. Water can still leak in even when the foot is covered. So it's best to keep the cast, bandage, splint, or boot away from water. If a fiberglass splint or cast becomes wet, you can dry it with a hair dryer on a cool setting. A vacuum cleaner with a hose attachment can also be used to pull air through the cast for speed drying.
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Remove the plastic bags and duct tape right away after bathing.
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To help reduce swelling, keep the injured ankle raised (elevated) above the level of the heart. Have your child lie down with a pillow under the foot as often as possible, especially while icing.
Follow-up care
Follow up with your child’s healthcare provider as advised. If your child is referred to an orthopedic doctor, see that doctor right away.
If X-rays were taken, you'll be told of any new findings that may affect your child’s care.
Special notes to parents
Ask your child’s healthcare provider about ankle exercises to improve your child’s ankle strength and range of motion. The exercises will help your child get back to normal activities more quickly.
When to get medical advice
Call your child's healthcare provider right away if any of these occur:
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The cast has a bad smell
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The cast has cracks or breaks
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The plaster cast or splint becomes wet or soft
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The fiberglass cast or splint stays wet for more than 24 hours
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The splint or cast is too tight or too loose
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The injured foot has more swelling or severe pain
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There is increased tightness or pain under the cast or splint
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The toes on the foot of the injured leg are cold, blue, numb, or tingly
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The injury doesn’t seem to be healing
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Your child can’t move the toes on the foot of the injured leg
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The skin looks blue, purple, or gray (discolored), has a blister, or is irritated