Bosworth Dislocation without Associated Fracture.

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.