Bosworth fracture

Bosworth fracture
SpecialtyOrthopedics

Bosworth fracture is a historical term that describes a type of ankle injury, where there is a broken bone in a pushed out of place ankle, caused by extreme twisting of the foot.[1][2] It presents with a swollen ankle with varying degrees of pain depending on severity, and may appear deformed.[2] It is a break of the distal fibula with an associated fixed posterior dislocation of the proximal fibular fragment which becomes trapped behind the posterior tibial tubercle.[2]

The injury is caused by severe external rotation of the ankle.[3] The ankle remains externally rotated after the injury, making interpretation of X-rays difficult which can lead to misdiagnosis and incorrect treatment.[4] The injury is most commonly treated by open reduction internal fixation as closed reduction is made difficult by the entrapment of the fibula behind the tibia.[3]

The entrapment of an intact fibula behind the tibia was described by Ashhurst and Bromer in 1922, who attributed the description of the mechanism of injury to Huguier's 1848 publication.[5] The injury involving fibular fracture with posterior dislocation was described by David M. Bosworth in 1947.[6]

It is rare.[3]

References

  1. ↑ Hunter, Tim B.; Peltier, Leonard F.; Lund, Pamela J. (1 May 2000). "Radiologic History Exhibit". RadioGraphics. pp. 819–836. doi:10.1148/radiographics.20.3.g00ma20819. Archived from the original on 16 September 2022. Retrieved 16 September 2022.
  2. 1 2 3 Natrajan, M. V. (2018). "20. Injuries of the ankle and foot". Natarajan’s Textbook of Orthopaedics & Traumatology (8th ed.). New Delhi: Wolters Kluwer. p. 335. ISBN 978-93-86691-49-1. Archived from the original on 2022-09-20. Retrieved 2022-09-14.
  3. 1 2 3 Perry, CR; Rice S; Rao A; Burdge R. (Oct 1983). "Posterior fracture-dislocation of the distal part of the fibula. Mechanism and staging of injury". J Bone Joint Surg Am. 65 (8): 1149–57. doi:10.2106/00004623-198365080-00016. PMID 6630259. Archived from the original on 2010-11-01. Retrieved 2009-10-10.
  4. ↑ Hoblitzell, RM; Ebraheim NA; Merritt T; Jackson WT. (1990). "Bosworth fracture-dislocation of the ankle. A case report and review of the literature". Clin Orthop Relat Res (255): 257–62. PMID 2112075.
  5. ↑ Ashhurst, APC; Bromer RS (1922). "Classification and Mechanism of Fractures of the Leg Bones Involving the Ankle. Based on a Study of Three Hundred Cases from the Episcopal Hospital". Arch. Surg. 4: 51–129. doi:10.1001/archsurg.1922.01110100060003. Archived from the original on 2019-06-27. Retrieved 2020-10-19.
  6. ↑ Bosworth, DM (Jan 1947). "Fracture-Dislocation of the Ankle with Fixed Displacement of the Fibula behind the Tibia". J Bone Joint Surg. 29: 130–135.
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