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Bosworth Dislocation without Associated Fracture
Austin D Williams1, Matthew Blue1, Christian Douthit1
1Department of Orthopaedic Surgery and Rehabilitation, Texas Tech University Health Sciences Center, 3601 4th St. MS 9436, Lubbock, TX 79430, USA.
Case Reports in Orthopedics
|May 30, 2018
Summary
A rare Bosworth dislocation, a severe ankle injury where the fibula lodges behind the tibia, was successfully treated. This case highlights effective open reduction and fixation using quadricortical screws without removing prior intramedullary nailing.
Area of Science:
- Orthopedic Surgery
- Traumatology
- Anatomy
Background:
- Bosworth fracture-dislocation is a rare and severe ankle injury involving distal fibula entrapment behind the tibia.
- This injury often resists closed reduction, necessitating surgical intervention.
- A variant, Bosworth dislocation without fracture, is exceptionally rare.
Observation:
- A 19-year-old male presented with a Bosworth dislocation.
- The patient had a history of ipsilateral tibia intramedullary nailing.
- Initial attempts at closed reduction were unsuccessful.
Findings:
- Open reduction was performed to directly reposition the fibula.
- The unstable syndesmosis was stabilized using two quadricortical screws.
- Successful fixation was achieved without the need to remove the existing intramedullary nail.
Implications:
- This case demonstrates a viable surgical approach for complex Bosworth dislocations, even in the presence of prior hardware.
- The use of two quadricortical screws is supported as an effective fixation method for syndesmotic instability in Bosworth dislocations.
- Timely and appropriate treatment is crucial for managing these severe ankle injuries to ensure optimal outcomes.
