Ankle arthroscopy-assisted closed reduction in Bosworth fracture dislocation

Area of Science:

• Orthopedic Surgery
• Radiology
• Sports Medicine

Background:

• The Bosworth fracture dislocation is a rare ankle injury often missed on initial radiographs.
• Early open reduction is typically recommended for Bosworth fractures.

Observation:

• This case study details a 51-year-old female with unusual Bosworth fracture dislocation features.
• Imaging revealed posterior detached dislocation of an intact distal fibula, loose osteochondral fragments in the tibiotalar joint, and deltoid ligament rupture.
• Delayed arthroscopy-assisted surgery was performed due to an infected wound.

Findings:

• The study successfully treated a rare Bosworth fracture variant with detached posterior dislocation of the intact distal fibula.
• Arthroscopy-assisted closed reduction, internal fixation, loose body removal, and deltoid ligament repair were performed 19 days post-injury.
• Postoperative imaging confirmed anatomic reduction, and the patient achieved pain-free ankle motion and resumed normal activities after 6 months.

Implications:

• This case highlights a rare variant of Bosworth fracture dislocation.
• Arthroscopy-assisted techniques are effective for managing these complex ankle fractures with intra-articular loose bodies.
• Prompt diagnosis and appropriate surgical intervention are crucial for favorable outcomes in Bosworth fracture dislocations.