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Related Concept Videos

Ankle Joint01:10

Ankle Joint

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The ankle is formed by the talocrural joint (crural = leg). It consists of the articulations between the talus bone of the foot and the distal ends of the tibia and fibula of the leg. The superior aspect of the talus bone is square-shaped and has three areas of articulation. The top of the talus articulates with the inferior tibia. This is the portion of the ankle joint that carries the body weight between the leg and foot. The sides of the talus are firmly held in position by the articulations...
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Fractures: Bone Repair01:27

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Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...
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Bosworth ankle fracture-dislocation: current concept review.

Jan Bartoníček1, Stefan Rammelt2, Michal Tuček1

  • 1Department of Orthopaedics, First Faculty of Medicine, Charles University and Military University Hospital Prague, U Vojenské Nemocnice, Prague, Czech Republic.

EFORT Open Reviews
|June 3, 2024
PubMed
Summary

Bosworth fractures (BF) are complex ankle injuries often misdiagnosed, requiring prompt surgical fixation. Early open reduction internal fixation is standard, though outcomes can be mixed, necessitating further long-term studies.

Keywords:
Ankle fractureBosworth fracturecompartment syndromeposterior malleolus fracture

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Area of Science:

  • Orthopedic Surgery
  • Traumatology
  • Radiology

Background:

  • Bosworth fracture (BF) is a distinct locked ankle fracture-dislocation.
  • It involves fibular fragment displacement behind the distal tibia, often misjudged and leading to complications.

Purpose of the Study:

  • To highlight the diagnostic importance of CT scans in Bosworth fractures.
  • To review current treatment standards and outcomes for Bosworth fractures.

Main Methods:

  • Review of Bosworth fracture characteristics and diagnostic imaging.
  • Analysis of treatment approaches, including open reduction internal fixation.
  • Evaluation of reported surgical outcomes and complications.

Main Results:

  • CT with 3D reconstruction is crucial for diagnosing BF and associated posterior malleolar fractures.
  • Non-operative treatment is generally ineffective; early open reduction internal fixation is the standard.
  • Surgical outcomes are mixed, with frequent reports of persistent pain, limited motion, and degenerative changes.

Conclusions:

  • Accurate diagnosis via CT is essential for appropriate management of Bosworth fractures.
  • Early surgical intervention is necessary, but long-term outcomes require further investigation.
  • Soft tissue complications like compartment syndrome are a concern in BF management.