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Improved functional outcome after early reduction in Bosworth fracture-dislocation
Yougun Won1, Gi-Soo Lee2, Jung-Mo Hwang2
1Department of Orthopaedic Surgery, Chungnam National University School of Medicine, Korea; Department of Orthopedic Surgery, Konyang University College of Medicine, Korea.
Bosworth ankle fractures, a type of posterior fibular fracture-dislocation, are more common than previously thought. Prompt diagnosis and surgical treatment lead to better patient outcomes and prevent permanent disability.
Area of Science:
- Orthopedic Surgery
- Traumatology
- Radiology
Background:
- Bosworth described a specific ankle fracture-dislocation involving the fibula.
- Limited epidemiological data exists for Bosworth ankle fractures.
- These fractures are frequently misdiagnosed.
Purpose of the Study:
- To determine the prevalence of Bosworth fracture-dislocations.
- To investigate the outcomes of missed Bosworth ankle fractures.
- To analyze patient characteristics and risk factors.
Main Methods:
- Retrospective analysis of 3405 ankle fracture inpatients (aged ≥15) from 2007-2016.
- Analysis of demographics, risk factors, fracture types, treatments, and outcomes.
- Comparison between emergency (<24h) and delayed surgery groups.
Main Results:
- Bosworth fracture-dislocations occurred in 51 of 3140 (1.62%) ankle fracture patients.
- Most patients were young adults with high-energy trauma (e.g., falls, traffic accidents).
- Emergency surgery (<24h) showed significantly better outcomes than delayed surgery.
Conclusions:
- The prevalence of Bosworth fracture-dislocations is higher than previously reported.
- Delayed diagnosis can lead to inappropriate treatment and permanent disability.
- Accurate diagnosis and prompt surgical intervention yield excellent results.
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