A Case Series of Bosworth Fracture-Dislocations and Review of 129 Reported Cases
https://doi.org/10.5704/MOJ.2211.013
- Author:
Fang C
1
;
Tang ZH
1
;
Yeoh CS
1
;
Tan GM
1
Author Information
1. Department of Orthopaedic Surgery, Khoo Teck Puat Hospital, Singapore
- Publication Type:Journal Article
- Keywords:
bosworth, fracture-dislocation, irreducible, ankle
- From:Malaysian Orthopaedic Journal
2022;16(No.3):76-85
- CountryMalaysia
- Language:English
-
Abstract:
Introduction: Bosworth fracture dislocations of the ankle
are rare injuries of the ankle caused by extreme external
rotation of the supinated foot where the proximal fibula
fracture fragment is posteriorly dislocated and entrapped
behind the posterior-lateral ridge of the tibia. This case series
aims to document three such cases treated in our institution
over a nine year period. We also provide a review of 129
cases in the existing literature.
Materials and methods: Medical records and relevant
radiographs for each patient were analysed and collected
from the time of presentation till the point of latest followup. During each clinic visit, all physical exam findings as
well as all complications were recorded. The American Foot
and Ankle Society (AOFAS) Hindfoot score was also
tabulated for each patient at the point of latest review.
Results: Closed reduction was unsuccessful in all three
patients, and all required open reduction. One patient had an
uncomplicated recovery whilst the remaining two suffered
significant soft tissue complications. One patient suffered
severe soft tissue swelling preventing primary closure at the
time of surgery, whilst another suffered post-operative
wound dehiscence and infection. Eventually all fractures
healed, and all three patients obtained satisfactory AOFAS
scores.
Conclusion: The diagnosis of Bosworth fracture
dislocations of the ankle is often delayed or missed, due to its
rare occurrence. Closed reduction is often unsuccessful, and
early open reduction is required to avoid poor clinical
outcomes due to severe soft tissue damage or even
compartment syndrome.
- Full text:16.2022my1277.pdf
