Boot top fractures.

Area of Science:

• Orthopedics
• Sports Medicine
• Traumatology

Background:

• Low transverse fractures of the tibiofibular complex, or boot top fractures, are increasingly common in ski injuries.
• These fractures present distinct demographic patterns compared to other tibial shaft fractures.
• A typical deformity involves backward angulation and distal fragment displacement.

Purpose of the Study:

• To analyze the characteristics of tibiofibular boot top fractures in skiers.
• To present a novel technique for reducing the typical deformity associated with these fractures.
• To compare recovery times and hospitalization periods with other tibial shaft fractures.

Main Methods:

• Analysis of 126 tibiofibular boot top fractures in patients aged 13 and older.
• Description of a reduction technique involving extreme plantar flexion, traction, and immobilization in full equinus.
• Comparison of hospitalization and recovery data with skiers sustaining other tibial shaft fractures.

Main Results:

• The described reduction technique was successful in 112 out of 126 cases.
• Patients with boot top fractures had significantly shorter hospitalizations and quicker return to normal activities.
• A new variant with forward angulation has emerged, possibly linked to modern skiing techniques.

Conclusions:

• The described technique offers an effective method for reducing typical boot top fractures.
• Boot top fractures generally have a better prognosis regarding recovery time compared to other tibial shaft fractures.
• Prevention strategies must adapt to new skiing techniques, necessitating safety bindings that release during backward falls.