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[The Bosworth ankle fracture (case report)]
D Jehlicka1, J Bartonícek, M Rysavý
1Ortopedicko-traumatologická klinika 3. LF UK a FNKV, Praha-Vinohrady.
Acta Chirurgiae Orthopaedicae Et Traumatologiae Cechoslovaca
|November 15, 2001
Summary
This case study details an unusual Bosworth fracture, a severe ankle injury. Surgical intervention led to excellent long-term outcomes, highlighting the importance of prompt treatment for this rare fracture-dislocation.
Area of Science:
- Orthopedic Surgery
- Traumatology
- Radiology
Background:
- The Bosworth fracture is a rare and severe ankle injury characterized by posterior dislocation of the distal fibula.
- It often involves fractures of the tibia and associated ligamentous damage, leading to significant instability.
Observation:
- A 26-year-old woman presented with an atypical Bosworth fracture (Weber C type), including a proximal fibula shaft fracture, medial malleolus fracture, and posterolateral tibial fragment fracture.
- The injury resulted in a fracture-dislocation with evident external rotation deformity of the foot.
Findings:
- The patient underwent open reduction and internal fixation, including medial malleolus fixation, anterior tibiofibular ligament repair, and fibula stabilization with a suprasyndesmal screw.
- Four years post-surgery, radiographs showed complete fracture healing in anatomical alignment without signs of osteoarthritis, and the patient reported high satisfaction with only a minor limitation in ankle dorsiflexion.
Implications:
- This case underscores the effectiveness of surgical management for complex Bosworth fractures, even in atypical presentations.
- Early and accurate diagnosis followed by appropriate surgical fixation is crucial for achieving favorable functional outcomes and preventing long-term complications such as post-traumatic arthritis.