{"id":11629,"date":"2026-09-10T09:55:51","date_gmt":"2026-09-10T07:55:51","guid":{"rendered":"https:\/\/www.smrekovit.si\/?p=11629"},"modified":"2026-09-10T13:58:00","modified_gmt":"2026-09-10T11:58:00","slug":"ankle-dislocation-case","status":"publish","type":"post","link":"https:\/\/www.smrekovit.si\/en\/izpah-gleznja-primer\/","title":{"rendered":"Ankle dislocation without fracture: documented course of recovery"},"content":{"rendered":"<h2 id=\"primer-na-kratko\" class=\"wp-block-heading\">Case in brief<\/h2>\n\n\n\n<section class=\"translation-block case-summary\" aria-labelledby=\"primer-na-kratko\">\n\n  <dl class=\"case-summary__grid\">\n\n    <div class=\"case-summary__item\">\n      <dt>Patient<\/dt>\n      <dd>44 years old at the time of injury<\/dd>\n    <\/div>\n\n    <div class=\"case-summary__item\">\n      <dt>Date of injury<\/dt>\n      <dd>\n        <time datetime=\"2018-11-09\">9 November 2018<\/time>\n      <\/dd>\n    <\/div>\n\n    <div class=\"case-summary__item\">\n      <dt>Injury<\/dt>\n      <dd>\n        Dislocation of the right ankle joint after landing\n      <\/dd>\n    <\/div>\n\n    <div class=\"case-summary__item\">\n      <dt>Emergency treatment<\/dt>\n      <dd>\n        Joint reduction followed by X-ray imaging; no associated fracture is described in the available documentation\n      <\/dd>\n    <\/div>\n\n    <div class=\"case-summary__item\">\n      <dt>Initial immobilization<\/dt>\n      <dd>\n        Non-weight-bearing plaster splint, later replaced at the patient\u2019s own decision\n        with a removable Vacoped system\n      <\/dd>\n    <\/div>\n\n    <div class=\"case-summary__item\">\n      <dt>Use of Smrekovit Klasik<\/dt>\n      <dd>\n        Smrekovit Klasik with a compress under the removable support system;\n        the compress was worn practically continuously and additional ointment was applied\n        approximately once daily\n      <\/dd>\n    <\/div>\n\n    <div class=\"case-summary__item\">\n      <dt>First steps without the brace<\/dt>\n      <dd>\n        Approximately one week after the injury\n      <\/dd>\n    <\/div>\n\n    <div class=\"case-summary__item\">\n      <dt>Walking without a limp<\/dt>\n      <dd>\n        Approximately two weeks after the injury, the patient reported walking\n        around <strong>1500 m without a limp<\/strong>\n      <\/dd>\n    <\/div>\n\n    <div class=\"case-summary__item\">\n      <dt>After approximately one month<\/dt>\n      <dd>\n        Several kilometres of walking per day and short running intervals of a few\n        dozen metres\n      <\/dd>\n    <\/div>\n\n    <div class=\"case-summary__item case-summary__item--wide\">\n      <dt>Documentation<\/dt>\n      <dd>\n        Emergency medical report, X-rays after reduction and follow-up\n        images, serial dated photographs and a subsequent written\n        reconstruction of the functional course\n      <\/dd>\n    <\/div>\n\n  <\/dl>\n\n  <p class=\"case-summary__note\">\n    The case is of interest because of the early functional recovery after a\n    documented ankle dislocation that required urgent reduction. The course of\n    recovery coincided in time with the use of Smrekovit Klasik with a compress,\n    but this is a single retrospectively documented observational case, so no\n    causal effectiveness of any individual intervention can be determined from it.\n  <\/p>\n\n<\/section>\n\n\n\n<div class=\"wp-block-rank-math-toc-block toc toc-naslov\" id=\"rank-math-toc\"><h2>Table of contents<\/h2><nav><ul><li class=\"\"><a href=\"#primer-na-kratko\">Case in brief<\/a><\/li><li class=\"\"><a href=\"#kako-je-prislo-do-izpaha\">How did the dislocation occur?<\/a><\/li><li class=\"\"><a href=\"#kaj-je-bilo-narejeno-na-urgenci\">What was done in the emergency department?<\/a><\/li><li class=\"\"><a href=\"#kako-je-potekala-domaca-oskrba\">How did home care proceed?<\/a><\/li><li class=\"\"><a href=\"#fotografski-potek-gleznja\">Photographic course of the ankle<\/a><\/li><li class=\"\"><a href=\"#kako-hitro-se-je-vrnila-funkcija-gleznja\">How quickly did ankle function return?<\/a><\/li><li class=\"\"><a href=\"#rtg-posnetki-po-repoziciji\">X-rays after reduction<\/a><\/li><li class=\"\"><a href=\"#kaj-je-pri-tem-primeru-pomembno\">What is important about this case?<\/a><\/li><li class=\"\"><a href=\"#dokumentacija-in-omejitve-primera\">Documentation and limitations of the case<\/a><\/li><li class=\"\"><a href=\"#h-2-ce-vas-zanima-uporaba-pri-zvinu-gleznja\">If you are interested in use for an ankle sprain<\/a><\/li><\/ul><\/nav><\/div>\n\n\n\n<h2 id=\"kako-je-prislo-do-izpaha\" class=\"wp-block-heading\">How did the dislocation occur?<\/h2>\n\n\n\n<div class=\"translation-block case-section\" id=\"nastanek-poskodbe\">\n\n  <p>\n    The injury occurred on <strong>9 November 2018<\/strong>, when a\n    44-year-old man injured his right ankle after a rapid jump or landing.\n    Because of the injury, he was transported by ambulance to the emergency\n    department.\n  <\/p>\n\n  <p>\n    On examination, the right ankle joint was\n    <strong>visibly deformed<\/strong>, and the skin over the joint was tense.\n    The pulse on the dorsum of the foot was palpable, while the patient was\n    otherwise described as stable on arrival.\n  <\/p>\n\n  <p>\n    The clinical picture was consistent with a <strong>dislocation of the\n    right ankle joint<\/strong>. The joint therefore first had to be urgently\n    returned to its anatomical position \u2013 a reduction was performed.\n  <\/p>\n\n  <p>\n    An important feature of the case is that the available documentation\n    <strong>does not describe an associated fracture<\/strong>. Fractures are\n    often associated with this type of injury, so according to the patient\u2019s\n    later account, he was initially also prepared for the possibility of\n    surgical treatment.\n  <\/p>\n\n<\/div>\n\n\n\n<h2 id=\"kaj-je-bilo-narejeno-na-urgenci\" class=\"wp-block-heading\">What was done in the emergency department?<\/h2>\n\n\n\n<div class=\"translation-block case-section\" id=\"urgentna-obravnava\">\n\n  <p>\n    In the emergency department, a\n    <strong>reduction of the right ankle joint<\/strong> was performed, meaning\n    the dislocated joint was returned to its anatomical position.\n  <\/p>\n\n  <p>\n    After the reduction, X-ray imaging of the right ankle and lower leg was\n    performed. The report states that the\n    <strong>ankle position was anatomical<\/strong>. No associated fracture is\n    described in the available documentation.\n  <\/p>\n\n  <p>\n    Because of the pain, the patient received analgesic treatment. The ankle was\n    then immobilized with a\n    <strong>below-knee non-weight-bearing plaster splint<\/strong>, and the patient\n    was also given crutches and instructions for follow-up.\n  <\/p>\n\n  <p>\n    Because immobilization was expected, \n    <strong>preventive treatment with low-molecular-weight heparin<\/strong>\n    was also started for the duration of immobilization.\n  <\/p>\n\n  <p>\n    A follow-up examination was planned four days later,\n    <strong>13 November 2018<\/strong>. Follow-up X-ray images from that day\n    have also been preserved.\n  <\/p>\n\n<\/div>\n\n\n\n<h2 id=\"kako-je-potekala-domaca-oskrba\" class=\"wp-block-heading\">How did home care proceed?<\/h2>\n\n\n\n<div class=\"translation-block case-section\" id=\"domaca-oskrba\">\n\n  <p>\n    After discharge from the emergency department, the patient\n    <strong>decided on his own to remove the plaster splint<\/strong>\n    and replace it with a removable immobilization boot,\n    <strong>Vacoped<\/strong>.\n  <\/p>\n\n  <p>\n    Under the boot, he used a compress with\n    <strong>Smrekovit Klasik<\/strong>. According to the original report, the compress\n    was worn practically continuously, during the day and at night, and the ointment\n    was reapplied to the compress approximately once daily.\n  <\/p>\n\n  <p>\n    According to his later account, the patient\n    <strong>walked with the immobilization boot from the beginning<\/strong>.\n    He tried his first cautious and controlled steps without the boot approximately\n    <strong>one week after the injury<\/strong>, after which he used it again\n    for protection against a possible misstep or fall.\n  <\/p>\n\n  <p>\n    Approximately <strong>two weeks after the injury<\/strong>, according to his own\n    report, he stopped using the boot. At that point, he was already walking without it,\n    but still cautiously and with additional ankle bandaging.\n  <\/p>\n\n  <p class=\"case-summary__note\">\n    Removal of the prescribed plaster splint and the transition to removable\n    immobilization were the patient\u2019s own decisions. This course is described here\n    as part of the documentation of this specific case and\n    <strong>does not represent a recommendation for the treatment of ankle dislocation<\/strong>.\n  <\/p>\n\n<\/div>\n\n\n\n<h2 id=\"fotografski-potek-gleznja\" class=\"wp-block-heading\">Photographic course of the ankle<\/h2>\n\n\n\n<div class=\"translation-block case-section\" id=\"fotografski-potek\">\n\n  <p>\n    From the fifth day after the injury, a series of dated photographs has been preserved,\n    allowing the changes in <strong>swelling, bruising and the appearance of the soft tissues<\/strong>\n    of the right ankle to be followed.\n  <\/p>\n\n  <p>\n    The photographs were not taken according to a standardized protocol, so they do not allow\n    precise measurement of the extent of swelling. However, the sequence does allow a visual\n    comparison of the course over approximately one month after the injury.\n  <\/p>\n\n<\/div>\n\n\n\n<div class=\"wp-block-group case-timeline\"><div class=\"wp-block-group__inner-container is-layout-constrained wp-block-group-is-layout-constrained\">\n<div class=\"wp-block-group case-timeline__item\"><div class=\"wp-block-group__inner-container is-layout-constrained wp-block-group-is-layout-constrained\">\n<div class=\"translation-block case-timeline__content\">\n\n  <div class=\"case-timeline__meta\">\n    <time datetime=\"2018-11-14\">14 November 2018<\/time>\n    <span>5 days after the injury<\/span>\n  <\/div>\n\n  <h3>Marked swelling and bruising<\/h3>\n\n  <p>\n    Five days after the dislocation, the photographs still show\n    <strong>marked swelling of the ankle and foot<\/strong> as well as extensive\n    bruising. A superficial skin injury is also present in the ankle area.\n  <\/p>\n\n  <p>\n    This is the first preserved photographic time point, so we use it\n    as the baseline for subsequent visual comparison.\n  <\/p>\n\n<\/div>\n\n\n<div class=\"wp-block-image case-image-overlay\">\n<figure class=\"aligncenter size-full is-resized\"><img loading=\"lazy\" decoding=\"async\" width=\"675\" height=\"1200\" src=\"https:\/\/www.smrekovit.si\/wp-content\/uploads\/2026\/09\/14.11.2018.webp\" alt=\"Swollen right ankle with bruising five days after dislocation on 14 November 2018\" class=\"wp-image-11634\" style=\"width:500px\" srcset=\"https:\/\/www.smrekovit.si\/wp-content\/uploads\/2026\/09\/14.11.2018.webp 675w, https:\/\/www.smrekovit.si\/wp-content\/uploads\/2026\/09\/14.11.2018-169x300.webp 169w, https:\/\/www.smrekovit.si\/wp-content\/uploads\/2026\/09\/14.11.2018-576x1024.webp 576w, https:\/\/www.smrekovit.si\/wp-content\/uploads\/2026\/09\/14.11.2018-7x12.webp 7w, https:\/\/www.smrekovit.si\/wp-content\/uploads\/2026\/09\/14.11.2018-600x1067.webp 600w\" sizes=\"auto, (max-width: 675px) 100vw, 675px\" \/><figcaption class=\"wp-element-caption\">14 November 2018 \u2013 five days after the dislocation, marked swelling of the ankle and foot and extensive bruising are still visible.<\/figcaption><\/figure>\n<\/div><\/div><\/div>\n\n\n\n<div class=\"wp-block-group case-timeline__item\"><div class=\"wp-block-group__inner-container is-layout-constrained wp-block-group-is-layout-constrained\">\n<div class=\"translation-block case-timeline__content\">\n\n  <div class=\"case-timeline__meta\">\n    <time datetime=\"2018-11-21\">21 November 2018<\/time>\n    <span>12 days after the injury<\/span>\n  <\/div>\n\n  <h3>The swelling is visibly less pronounced<\/h3>\n\n  <p>\n    On the twelfth day after the injury, the ankle is still swollen in the photographs,\n    but the <strong>swelling is clearly less pronounced than on day five<\/strong>.\n    The extent of visible bruising is also decreasing.\n  <\/p>\n\n  <p>\n    During this period, the patient was already taking cautious steps without\n    the immobilization boot, although he still used it for protection.\n  <\/p>\n\n<\/div>\n\n\n<div class=\"wp-block-image case-image-overlay\">\n<figure class=\"aligncenter size-full is-resized\"><img loading=\"lazy\" decoding=\"async\" width=\"1069\" height=\"1900\" src=\"https:\/\/www.smrekovit.si\/wp-content\/uploads\/2026\/09\/zvin-21.11.2018.webp\" alt=\"Right ankle 12 days after dislocation with reduced swelling and bruising\" class=\"wp-image-11637\" style=\"width:500px\" srcset=\"https:\/\/www.smrekovit.si\/wp-content\/uploads\/2026\/09\/zvin-21.11.2018.webp 1069w, https:\/\/www.smrekovit.si\/wp-content\/uploads\/2026\/09\/zvin-21.11.2018-169x300.webp 169w, https:\/\/www.smrekovit.si\/wp-content\/uploads\/2026\/09\/zvin-21.11.2018-576x1024.webp 576w, https:\/\/www.smrekovit.si\/wp-content\/uploads\/2026\/09\/zvin-21.11.2018-768x1365.webp 768w, https:\/\/www.smrekovit.si\/wp-content\/uploads\/2026\/09\/zvin-21.11.2018-864x1536.webp 864w, https:\/\/www.smrekovit.si\/wp-content\/uploads\/2026\/09\/zvin-21.11.2018-7x12.webp 7w, https:\/\/www.smrekovit.si\/wp-content\/uploads\/2026\/09\/zvin-21.11.2018-600x1066.webp 600w\" sizes=\"auto, (max-width: 1069px) 100vw, 1069px\" \/><figcaption class=\"wp-element-caption\">21 November 2018 \u2013 on the twelfth day after the injury, the swelling is visibly less pronounced compared with the photographs from 14 November.<\/figcaption><\/figure>\n<\/div><\/div><\/div>\n\n\n\n<div class=\"wp-block-group case-timeline__item\"><div class=\"wp-block-group__inner-container is-layout-constrained wp-block-group-is-layout-constrained\">\n<div class=\"translation-block case-timeline__content\">\n\n  <div class=\"case-timeline__meta\">\n    <time datetime=\"2018-11-24\">24 November 2018<\/time>\n    <span>15 days after the injury<\/span>\n  <\/div>\n\n  <h3>Only minor residual swelling remains<\/h3>\n\n  <p>\n    Fifteen days after the injury, the shape of the ankle in the photograph is already much\n    closer to its usual appearance. Some <strong>residual swelling and skin discoloration<\/strong>\n    are still present, but both are much less pronounced than in the first images.\n  <\/p>\n\n  <p>\n    At around this time, according to the later written reconstruction, the patient had\n    already stopped regularly using the immobilization boot and completed a walk of\n    approximately <strong>1500 metres without limping<\/strong>.\n    This functional information is based on the patient\u2019s report and was not objectively measured.\n  <\/p>\n\n<\/div>\n\n\n<div class=\"wp-block-image case-image-overlay\">\n<figure class=\"aligncenter size-full is-resized\"><img loading=\"lazy\" decoding=\"async\" width=\"1069\" height=\"1900\" src=\"https:\/\/www.smrekovit.si\/wp-content\/uploads\/2026\/09\/zvin-24.11.2018.webp\" alt=\"Right ankle 15 days after dislocation with minor residual swelling\" class=\"wp-image-11640\" style=\"width:500px\" srcset=\"https:\/\/www.smrekovit.si\/wp-content\/uploads\/2026\/09\/zvin-24.11.2018.webp 1069w, https:\/\/www.smrekovit.si\/wp-content\/uploads\/2026\/09\/zvin-24.11.2018-169x300.webp 169w, https:\/\/www.smrekovit.si\/wp-content\/uploads\/2026\/09\/zvin-24.11.2018-576x1024.webp 576w, https:\/\/www.smrekovit.si\/wp-content\/uploads\/2026\/09\/zvin-24.11.2018-768x1365.webp 768w, https:\/\/www.smrekovit.si\/wp-content\/uploads\/2026\/09\/zvin-24.11.2018-864x1536.webp 864w, https:\/\/www.smrekovit.si\/wp-content\/uploads\/2026\/09\/zvin-24.11.2018-7x12.webp 7w, https:\/\/www.smrekovit.si\/wp-content\/uploads\/2026\/09\/zvin-24.11.2018-600x1066.webp 600w\" sizes=\"auto, (max-width: 1069px) 100vw, 1069px\" \/><figcaption class=\"wp-element-caption\">24 November 2018 \u2013 fifteen days after the injury, the swelling is already significantly less pronounced, although some residual skin changes are still present.<\/figcaption><\/figure>\n<\/div><\/div><\/div>\n\n\n\n<div class=\"wp-block-group case-timeline__item\"><div class=\"wp-block-group__inner-container is-layout-constrained wp-block-group-is-layout-constrained\">\n<div class=\"translation-block case-timeline__content\">\n\n  <div class=\"case-timeline__meta\">\n    <time datetime=\"2018-12-06\">6 December 2018<\/time>\n    <span>27 days after the injury<\/span>\n  <\/div>\n\n  <h3>The appearance of the ankle is approaching normal<\/h3>\n\n  <p>\n    Just under a month after the injury, pronounced swelling is no longer\n    visible in the photograph. The contours of the ankle are clearly visible,\n    while <strong>residual skin discoloration<\/strong> remains in areas\n    affected by the previous bruising and superficial injury.\n  <\/p>\n\n<\/div>\n\n\n<div class=\"wp-block-image case-image-overlay\">\n<figure class=\"aligncenter size-full is-resized\"><img loading=\"lazy\" decoding=\"async\" width=\"1069\" height=\"1900\" src=\"https:\/\/www.smrekovit.si\/wp-content\/uploads\/2026\/09\/zvin-6.12.2018.webp\" alt=\"Right ankle 27 days after dislocation without pronounced swelling\" class=\"wp-image-11643\" style=\"width:500px\" srcset=\"https:\/\/www.smrekovit.si\/wp-content\/uploads\/2026\/09\/zvin-6.12.2018.webp 1069w, https:\/\/www.smrekovit.si\/wp-content\/uploads\/2026\/09\/zvin-6.12.2018-169x300.webp 169w, https:\/\/www.smrekovit.si\/wp-content\/uploads\/2026\/09\/zvin-6.12.2018-576x1024.webp 576w, https:\/\/www.smrekovit.si\/wp-content\/uploads\/2026\/09\/zvin-6.12.2018-768x1365.webp 768w, https:\/\/www.smrekovit.si\/wp-content\/uploads\/2026\/09\/zvin-6.12.2018-864x1536.webp 864w, https:\/\/www.smrekovit.si\/wp-content\/uploads\/2026\/09\/zvin-6.12.2018-7x12.webp 7w, https:\/\/www.smrekovit.si\/wp-content\/uploads\/2026\/09\/zvin-6.12.2018-600x1066.webp 600w\" sizes=\"auto, (max-width: 1069px) 100vw, 1069px\" \/><figcaption class=\"wp-element-caption\">6 December 2018 \u2013 just under a month after the injury, pronounced swelling is no longer visible; mainly residual skin discoloration remains.<\/figcaption><\/figure>\n<\/div><\/div><\/div>\n\n\n\n<div class=\"wp-block-group case-timeline__item\"><div class=\"wp-block-group__inner-container is-layout-constrained wp-block-group-is-layout-constrained\">\n<div class=\"translation-block case-timeline__content\">\n\n  <div class=\"case-timeline__meta\">\n    <time datetime=\"2018-12-14\">14 December 2018<\/time>\n    <span>35 days after the injury<\/span>\n  <\/div>\n\n  <h3>Last preserved photographic follow-up<\/h3>\n\n  <p>\n    Five weeks after the injury, the last preserved photographs show that\n    <strong>pronounced swelling is no longer visible<\/strong>. The shape of the ankle\n    appears normalized, while minor residual changes in skin colour are still present.\n  <\/p>\n\n  <p>\n    The photographs themselves do not allow an assessment of stability, mobility or\n    ligament healing. The functional course is therefore documented separately on the\n    basis of the patient\u2019s written statements.\n  <\/p>\n\n<\/div>\n\n\n<div class=\"wp-block-image case-image-overlay\">\n<figure class=\"aligncenter size-full is-resized\"><img loading=\"lazy\" decoding=\"async\" width=\"1069\" height=\"1900\" src=\"https:\/\/www.smrekovit.si\/wp-content\/uploads\/2026\/09\/zvin-14.12.2018.webp\" alt=\"Right ankle five weeks after dislocation on 14 December 2018\" class=\"wp-image-11644\" style=\"width:500px\" srcset=\"https:\/\/www.smrekovit.si\/wp-content\/uploads\/2026\/09\/zvin-14.12.2018.webp 1069w, https:\/\/www.smrekovit.si\/wp-content\/uploads\/2026\/09\/zvin-14.12.2018-169x300.webp 169w, https:\/\/www.smrekovit.si\/wp-content\/uploads\/2026\/09\/zvin-14.12.2018-576x1024.webp 576w, https:\/\/www.smrekovit.si\/wp-content\/uploads\/2026\/09\/zvin-14.12.2018-768x1365.webp 768w, https:\/\/www.smrekovit.si\/wp-content\/uploads\/2026\/09\/zvin-14.12.2018-864x1536.webp 864w, https:\/\/www.smrekovit.si\/wp-content\/uploads\/2026\/09\/zvin-14.12.2018-7x12.webp 7w, https:\/\/www.smrekovit.si\/wp-content\/uploads\/2026\/09\/zvin-14.12.2018-600x1066.webp 600w\" sizes=\"auto, (max-width: 1069px) 100vw, 1069px\" \/><figcaption class=\"wp-element-caption\">14 December 2018 \u2013 last preserved photographic follow-up, five weeks after the injury; pronounced swelling is no longer visible.<\/figcaption><\/figure>\n<\/div><\/div><\/div>\n<\/div><\/div>\n\n\n\n<h2 id=\"kako-hitro-se-je-vrnila-funkcija-gleznja\" class=\"wp-block-heading\">How quickly did ankle function return?<\/h2>\n\n\n\n<div class=\"translation-block case-section\" id=\"funkcionalni-potek\">\n\n  <p>\n    In addition to the photographic follow-up, the patient\u2019s later written\n    reconstruction of the return to walking and loading of the injured\n    ankle has also been preserved. The functional milestones therefore\n    rely mainly on the <strong>patient\u2019s own report<\/strong> and were not\n    verified using standardized functional tests.\n  <\/p>\n\n  <dl class=\"case-summary__grid\">\n\n    <div class=\"case-summary__item\">\n      <dt>Approximately 1 week<\/dt>\n      <dd>\n        First cautious and controlled steps without the immobilization\n        boot. After trying this, the patient resumed using it mainly\n        for protection against a misstep or fall.\n      <\/dd>\n    <\/div>\n\n    <div class=\"case-summary__item\">\n      <dt>Approximately 2 weeks<\/dt>\n      <dd>\n        The patient stopped regularly using the immobilization boot and,\n        with additional bandaging, completed a walk of approximately\n        <strong>1500 metres without limping<\/strong>.\n      <\/dd>\n    <\/div>\n\n    <div class=\"case-summary__item\">\n      <dt>Approximately 1 month<\/dt>\n      <dd>\n        According to his own report, he was already walking\n        <strong>several kilometres per day without pain<\/strong>.\n      <\/dd>\n    <\/div>\n\n    <div class=\"case-summary__item\">\n      <dt>Approximately 1 month<\/dt>\n      <dd>\n        He also began incorporating\n        <strong>short running intervals of several dozen metres<\/strong>\n        into his walking.\n      <\/dd>\n    <\/div>\n\n  <\/dl>\n\n  <p>\n    Considering the initial condition, when the dislocation required urgent\n    reduction and non-weight-bearing immobilization was prescribed at discharge,\n    the described milestones indicate an <strong>early return to functional loading\n    of the ankle<\/strong>.\n  <\/p>\n\n  <p class=\"case-summary__note\">\n    The functional milestones describe the ability to walk and bear weight, but not\n    necessarily complete anatomical healing of the injured structures. The preserved\n    documentation contains no standardized measurements of mobility, stability,\n    strength or pain, and no soft-tissue imaging was performed that could have more\n    precisely defined the extent of the ligament injury and its healing.\n  <\/p>\n\n<\/div>\n\n\n\n<h2 id=\"rtg-posnetki-po-repoziciji\" class=\"wp-block-heading\">X-rays after reduction<\/h2>\n\n\n\n<div class=\"translation-block case-section\" id=\"rtg-spremljanje\">\n\n  <p>\n    X-ray imaging was performed\n    <strong>on 9 November 2018 after reduction<\/strong> of the right\n    ankle joint. The emergency report states that after reduction\n    the <strong>position of the ankle was anatomical<\/strong>.\n  <\/p>\n\n  <p>\n    No associated fracture is described in the available documentation.\n    Follow-up X-rays from\n    <strong>13 November 2018<\/strong>, four days after the injury, have also been preserved.\n  <\/p>\n\n  <p>\n    The images are shown here as part of the case documentation and not as\n    an independent radiological interpretation. They also do not allow\n    assessment of the extent of ligament injury or ligament healing.\n  <\/p>\n\n<\/div>\n\n\n\n<figure class=\"wp-block-gallery has-nested-images columns-default is-cropped wp-block-gallery-1 is-layout-flex wp-block-gallery-is-layout-flex\">\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"940\" height=\"926\" data-id=\"11647\" src=\"https:\/\/www.smrekovit.si\/wp-content\/uploads\/2026\/09\/9-11-2018-AP.webp\" alt=\"AP X-ray of the right ankle after reduction on 9 November 2018\" class=\"wp-image-11647\" srcset=\"https:\/\/www.smrekovit.si\/wp-content\/uploads\/2026\/09\/9-11-2018-AP.webp 940w, https:\/\/www.smrekovit.si\/wp-content\/uploads\/2026\/09\/9-11-2018-AP-300x296.webp 300w, https:\/\/www.smrekovit.si\/wp-content\/uploads\/2026\/09\/9-11-2018-AP-768x757.webp 768w, https:\/\/www.smrekovit.si\/wp-content\/uploads\/2026\/09\/9-11-2018-AP-12x12.webp 12w, https:\/\/www.smrekovit.si\/wp-content\/uploads\/2026\/09\/9-11-2018-AP-600x591.webp 600w, https:\/\/www.smrekovit.si\/wp-content\/uploads\/2026\/09\/9-11-2018-AP-100x100.webp 100w\" sizes=\"auto, (max-width: 940px) 100vw, 940px\" \/><figcaption class=\"wp-element-caption\">9 November 2018 \u2013 AP X-ray of the right ankle after reduction.<\/figcaption><\/figure>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"940\" height=\"926\" data-id=\"11648\" src=\"https:\/\/www.smrekovit.si\/wp-content\/uploads\/2026\/09\/9-11-2018-LAT.webp\" alt=\"Lateral X-ray of the right ankle after reduction on 9 November 2018\" class=\"wp-image-11648\" srcset=\"https:\/\/www.smrekovit.si\/wp-content\/uploads\/2026\/09\/9-11-2018-LAT.webp 940w, https:\/\/www.smrekovit.si\/wp-content\/uploads\/2026\/09\/9-11-2018-LAT-300x296.webp 300w, https:\/\/www.smrekovit.si\/wp-content\/uploads\/2026\/09\/9-11-2018-LAT-768x757.webp 768w, https:\/\/www.smrekovit.si\/wp-content\/uploads\/2026\/09\/9-11-2018-LAT-12x12.webp 12w, https:\/\/www.smrekovit.si\/wp-content\/uploads\/2026\/09\/9-11-2018-LAT-600x591.webp 600w, https:\/\/www.smrekovit.si\/wp-content\/uploads\/2026\/09\/9-11-2018-LAT-100x100.webp 100w\" sizes=\"auto, (max-width: 940px) 100vw, 940px\" \/><figcaption class=\"wp-element-caption\">9 November 2018 \u2013 lateral X-ray of the right ankle after reduction.<\/figcaption><\/figure>\n<\/figure>\n\n\n\n<div style=\"height:100px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<div class=\"translation-block case-section\">\n\n  <p>\n    The emergency report accompanying these images states that the\n    <strong>ankle was in anatomical alignment after reduction<\/strong>.\n  <\/p>\n\n<\/div>\n\n\n\n<div style=\"height:100px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<figure class=\"wp-block-gallery has-nested-images columns-default is-cropped wp-block-gallery-2 is-layout-flex wp-block-gallery-is-layout-flex\">\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"499\" data-id=\"11650\" src=\"https:\/\/www.smrekovit.si\/wp-content\/uploads\/2026\/09\/13-11-2018-AP-1024x499.webp\" alt=\"Follow-up AP X-ray of the right ankle on 13 November 2018\" class=\"wp-image-11650\" srcset=\"https:\/\/www.smrekovit.si\/wp-content\/uploads\/2026\/09\/13-11-2018-AP-1024x499.webp 1024w, https:\/\/www.smrekovit.si\/wp-content\/uploads\/2026\/09\/13-11-2018-AP-300x146.webp 300w, https:\/\/www.smrekovit.si\/wp-content\/uploads\/2026\/09\/13-11-2018-AP-768x374.webp 768w, https:\/\/www.smrekovit.si\/wp-content\/uploads\/2026\/09\/13-11-2018-AP-1536x749.webp 1536w, https:\/\/www.smrekovit.si\/wp-content\/uploads\/2026\/09\/13-11-2018-AP-18x9.webp 18w, https:\/\/www.smrekovit.si\/wp-content\/uploads\/2026\/09\/13-11-2018-AP-600x292.webp 600w, https:\/\/www.smrekovit.si\/wp-content\/uploads\/2026\/09\/13-11-2018-AP.webp 1900w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><figcaption class=\"wp-element-caption\">13 November 2018 \u2013 follow-up AP X-ray four days after the injury.<\/figcaption><\/figure>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"940\" height=\"926\" data-id=\"11649\" src=\"https:\/\/www.smrekovit.si\/wp-content\/uploads\/2026\/09\/13-11-2018-LAT.webp\" alt=\"Follow-up lateral X-ray of the right ankle on 13 November 2018\" class=\"wp-image-11649\" srcset=\"https:\/\/www.smrekovit.si\/wp-content\/uploads\/2026\/09\/13-11-2018-LAT.webp 940w, https:\/\/www.smrekovit.si\/wp-content\/uploads\/2026\/09\/13-11-2018-LAT-300x296.webp 300w, https:\/\/www.smrekovit.si\/wp-content\/uploads\/2026\/09\/13-11-2018-LAT-768x757.webp 768w, https:\/\/www.smrekovit.si\/wp-content\/uploads\/2026\/09\/13-11-2018-LAT-12x12.webp 12w, https:\/\/www.smrekovit.si\/wp-content\/uploads\/2026\/09\/13-11-2018-LAT-600x591.webp 600w, https:\/\/www.smrekovit.si\/wp-content\/uploads\/2026\/09\/13-11-2018-LAT-100x100.webp 100w\" sizes=\"auto, (max-width: 940px) 100vw, 940px\" \/><figcaption class=\"wp-element-caption\">13. november 2018 \u2013 kontrolni stranski posnetek \u0161tiri dni po po\u0161kodbi.<\/figcaption><\/figure>\n<\/figure>\n\n\n\n<h2 id=\"kaj-je-pri-tem-primeru-pomembno\" class=\"wp-block-heading\">What is important about this case?<\/h2>\n\n\n\n<div class=\"translation-block case-section\" id=\"pomen-primera\">\n\n  <p>\n    The case is particularly interesting because this was not a mild sprain, but a\n    <strong>dislocation of the right ankle joint that required urgent\n    reduction<\/strong>. After reduction, the ankle was initially immobilized\n    with a non-weight-bearing plaster splint.\n  <\/p>\n<p>\n  Read more about what happens to the ligaments in an ankle sprain, how injuries\n  differ in severity and how recovery usually progresses in the article\n  <a href=\"\/en\/ankle-sprain\/\">Ankle sprain: symptoms and recovery<\/a>.\n  If you are primarily interested in the practical use of Smrekovit products for a sprain,\n  the instructions are collected in the section\n  <a href=\"\/en\/instructions\/injuries\/#zvin\">Use for ankle sprain<\/a>.\n<\/p>\n\n  <p>\n    Despite the initial severity of the injury, according to the patient\u2019s later\n    written report, he took his first cautious steps without the immobilization boot\n    approximately <strong>one week after the injury<\/strong>, and about\n    two weeks after the injury he walked around\n    <strong>1500 metres without limping<\/strong>.\n  <\/p>\n\n  <p>\n    Approximately one month after the injury, according to his own report, he was already walking\n    <strong>several kilometres per day without pain<\/strong> and was also\n    incorporating short running intervals of several dozen metres into his walking.\n    The photographic series from the same period also shows a gradual reduction\n    in swelling and bruising and a return towards the ankle\u2019s usual appearance.\n  <\/p>\n<p>\n  For context, comparison with the published literature is also informative.\n  A systematic review of 154 reported cases of ankle dislocation without\n  an associated fracture found an average immobilization period of slightly\n  more than six weeks, with a range of 2 to 16 weeks. In this context,\n  discontinuing regular use of the immobilization boot approximately two weeks\n  after the injury was early in this case. Direct comparison between\n  individual cases is not possible, however, because of differences in\n  the injuries and treatment.\n<\/p>\n  <p>\n    This entire course coincided with the use of\n    <strong>Smrekovit Klasik with a compress<\/strong> under the removable\n    immobilization boot. However, a single retrospectively documented\n    case does not allow us to determine how much of the observed course can be\n    attributed to the product and how much to natural healing, reduction,\n    immobilization and gradual loading of the joint.\n  <\/p>\n\n  <p>\n    The particular value of this case therefore lies mainly in the\n    <strong>combination of medical documentation, X-rays,\n    serial photographs and function-related milestones reconstructed in writing<\/strong>,\n    which allows the course after the injury to be followed relatively well.\n  <\/p>\n\n<\/div>\n\n\n\n<h2 id=\"dokumentacija-in-omejitve-primera\" class=\"wp-block-heading\">Documentation and limitations of the case<\/h2>\n\n\n\n<div class=\"translation-block case-section\" id=\"dokumentacija-in-omejitve\">\n\n  <p>\n    The case was retrospectively reconstructed from several preserved sources:\n    <strong>the emergency report, X-rays taken after reduction and at the\n    follow-up examination, serial dated photographs, the original case report\n    and later written correspondence with the patient<\/strong>.\n  <\/p>\n\n  <p>\n    The strongest part of the documentation consists of the medical record of\n    the reduction and immobilization, the preserved X-rays and the photographic\n    series, which allows changes in the appearance of the ankle to be followed\n    over time.\n  <\/p>\n\n  <p>\n    Functional milestones, such as the first steps without the immobilization boot,\n    approximately 1500 metres of walking without limping and later walking several\n    kilometres per day, are based on the <strong>patient\u2019s later written reconstruction<\/strong>.\n    These data were not verified using standardized functional tests.\n  <\/p>\n\n  <p>\n    No X-ray taken before reduction is preserved in the available documentation,\n    so the original direction of the dislocation cannot be reliably reconstructed.\n    No soft-tissue imaging, such as magnetic resonance imaging, was performed either,\n    which could have defined the extent of the ligament injury more precisely.\n  <\/p>\n\n  <p>\n    No standardized measurements of swelling, range of motion, stability,\n    strength or pain have been preserved. The photographs therefore allow mainly\n    the <strong>visual course of swelling, bruising and soft-tissue changes<\/strong>\n    to be followed, but not anatomical ligament healing or complete functional\n    normalization of the joint.\n  <\/p>\n\n  <p>\n    Another important uncontrolled factor is the patient\u2019s decision to remove the\n    prescribed plaster splint after discharge and replace it with a removable\n    immobilization boot. The course of recovery may also have been influenced by\n    reduction, immobilization, gradual loading, the natural healing process and\n    other factors that cannot be separated from one another in an individual case.\n  <\/p>\n\n  <p>\n    This is a <strong>single retrospectively documented observational case\n    without a control group<\/strong>. It therefore cannot be used to determine\n    the causal effectiveness of any individual intervention or to predict the same\n    course in other injuries.\n  <\/p>\n\n<\/div>\n\n\n\n<h2 id=\"h-2-ce-vas-zanima-uporaba-pri-zvinu-gleznja\" class=\"wp-block-heading\">If you are interested in use for an ankle sprain<\/h2>\n\n\n\n<div class=\"translation-block case-section case-next-step\">\n\n  <p>\n    For more information about ligament injuries, symptoms and the usual course\n    of recovery, read the article\n    <a href=\"\/en\/ankle-sprain\/\">Ankle sprain: symptoms and recovery<\/a>.\n  <\/p>\n\n  <p>\n    Specific instructions for using Smrekovit products for an ankle sprain can be found\n    in the section\n    <a href=\"\/en\/instructions\/injuries\/#zvin\">Use for ankle sprain<\/a>.\n  <\/p>\n\n<\/div>\n\n\n\n<div class=\"translation-block article-footer-meta\">\n\n  <div class=\"article-footer-meta__info\">\n\n    <div class=\"article-footer-meta__item\">\n      <span class=\"article-footer-meta__label\">Author<\/span>\n      <span class=\"article-footer-meta__value\">\n        Matic Konc, biomedical laboratory engineer\n      <\/span>\n    <\/div>\n\n    <div class=\"article-footer-meta__item\">\n      <span class=\"article-footer-meta__label\">Date prepared<\/span>\n      <time class=\"article-footer-meta__value\" datetime=\"2026-09-10\">\n        10 September 2026\n      <\/time>\n    <\/div>\n\n  <\/div>\n\n  <div class=\"article-footer-meta__sources\">\n\n    <h3>Case documentation<\/h3>\n\n    <ul>\n      <li>\n        <a href=\"\/wp-content\/uploads\/2026\/09\/0022018_Javni_case_report_izpah_gleznja_Smrekovit_Klasik.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">\n          Documented observational case 0022018\n        <\/a>\n        <span>\n          Smrekovit, 2026 \u2013 retrospective report on the course following\n          dislocation of the right ankle joint; no associated fracture is\n          described in the available documentation\n        <\/span>\n      <\/li>\n    <\/ul>\n\n    <h3>Primary documentation sources<\/h3>\n\n    <ul>\n      <li>\n        Emergency report dated 9 November 2018 documenting\n        reduction of the right ankle joint\n      <\/li>\n\n      <li>\n        X-rays of the right ankle after reduction dated\n        9 November 2018\n      <\/li>\n\n      <li>\n        Follow-up X-rays dated 13 November 2018\n      <\/li>\n\n      <li>\n        Original dated photographs of the ankle from the period\n        between 14 November and 14 December 2018\n      <\/li>\n\n      <li>\n        Original case report prepared in 2020\n      <\/li>\n\n      <li>\n        Written correspondence with the patient from December 2019 and January 2020,\n        used to reconstruct the functional course\n      <\/li>\n    <\/ul>\n\n    <h3>Scientific literature<\/h3>\n\n    <ul>\n      <li>\n        Wight L, Owen D, Goldbloom D, Knupp M.\n        Pure Ankle Dislocation: A systematic review of the literature\n        and estimation of incidence.\n        <em>Injury.<\/em> 2017;48(10):2027\u20132034.\n        doi: 10.1016\/j.injury.2017.08.011.\n      <\/li>\n\n      <li>\n        Gan TJW, Li YX, Liu X, Zhang H.\n        Pure Ankle Dislocation Without Associated Fracture:\n        A Series of Cases and Our Clinical Experience.\n        <em>Indian Journal of Orthopaedics.<\/em>\n        2022;56(8):1370\u20131377.\n        doi: 10.1007\/s43465-022-00682-9.\n      <\/li>\n    <\/ul>\n\n    <h3>Practical guidance<\/h3>\n\n    <ul>\n      <li>\n        <a href=\"\/en\/ankle-sprain\/\">\n          Ankle sprain: symptoms and recovery\n        <\/a>\n        <span>\n          Overview of ligament injury, symptoms and the course of recovery\n        <\/span>\n      <\/li>\n\n      <li>\n        <a href=\"\/en\/instructions\/injuries\/#zvin\">\n          Use for ankle sprain\n        <\/a>\n        <span>\n          Current practical instructions for using Smrekovit products\n          for an ankle sprain\n        <\/span>\n      <\/li>\n    <\/ul>\n\n    <p class=\"article-footer-meta__note\">\n      The case was retrospectively reconstructed from preserved medical\n      documentation, X-rays, serial photographs, the original report and\n      later written correspondence with the patient. Functional milestones\n      were not verified using standardized tests, and the extent of the\n      ligament injury was not assessed by magnetic resonance imaging.\n      This is a single documented observational case without a control\n      group, so it cannot be used to determine the causal effectiveness\n      of any individual intervention or to generalize the outcome to other injuries.\n    <\/p>\n\n  <\/div>\n\n<\/div>","protected":false},"excerpt":{"rendered":"<p>Documented case of a 77-year-old patient with venous and heart failure whose open lower leg wound was monitored after injury using serial photographs and measurements. During 19 days of documented use of Smrekovit Klasik, the estimated open wound area decreased from 25.08 cm\u00b2 to 0 cm\u00b2.<\/p>","protected":false},"author":2,"featured_media":11630,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[153,159,160],"tags":[],"class_list":["post-11629","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uporaba-v-praksi","category-dokumentirani-primeri","category-poskodbe-in-preobremenitve"],"_links":{"self":[{"href":"https:\/\/www.smrekovit.si\/en\/wp-json\/wp\/v2\/posts\/11629","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.smrekovit.si\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.smrekovit.si\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.smrekovit.si\/en\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.smrekovit.si\/en\/wp-json\/wp\/v2\/comments?post=11629"}],"version-history":[{"count":15,"href":"https:\/\/www.smrekovit.si\/en\/wp-json\/wp\/v2\/posts\/11629\/revisions"}],"predecessor-version":[{"id":11668,"href":"https:\/\/www.smrekovit.si\/en\/wp-json\/wp\/v2\/posts\/11629\/revisions\/11668"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.smrekovit.si\/en\/wp-json\/wp\/v2\/media\/11630"}],"wp:attachment":[{"href":"https:\/\/www.smrekovit.si\/en\/wp-json\/wp\/v2\/media?parent=11629"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.smrekovit.si\/en\/wp-json\/wp\/v2\/categories?post=11629"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.smrekovit.si\/en\/wp-json\/wp\/v2\/tags?post=11629"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}