Bosworth Fractures of the Ankle: A Systematic Literature Review

Lucenti, Ludovico; Testa, Gianluca; Nocera, Chiara; Culmone, Annalisa; Dell’Agli, Eleonora; Pavone, Vito

doi:10.3390/jpm13050713

Cited by 2 publications

(2 citation statements)

References 31 publications

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“…More detailed information could be provided by postoperative CT imaging which, however, is currently employed by a few authors only ( 50 , 73 , 76 ). Overall, there is a need for clinical studies reporting the medium- and long-term results of BF treatment in a larger number of patients ( 83 ).…”

Section: Resultsmentioning

confidence: 99%

Bosworth ankle fracture-dislocation: current concept review

Bartoníček,

Rammelt,

Tuček

2024

EFORT Open Reviews

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Bosworth fracture (BF) is a special type of locked ankle fracture-dislocation, characterized by displacement of a fragment of the fractured fibula from the fibular notch behind the posterior surface of the distal tibia. BF is a complex injury affecting multiple structures of the ankle joint, which is still frequently misjudged even today, potentially leading to severe complications. CT examination, including 3D reconstructions, should be the diagnostic standard in BF, as it provides a complete picture of the fracture pathoanatomy, most prominently the morphology of the frequently associated posterior malleolar fracture. BF requires early reduction of the displaced fibular fragment without repeated attempts on closed reduction. Non-operative treatment of BF almost always fails. The standard treatment procedure is early open reduction internal fixation. Due to the relative severity and paucity of the injury, BF seems to be particularly prone to soft tissue complications, including compartment syndrome. The results of operative treatment are mixed. Many studies report persistent pain even after a short time interval, with limitations of the range of motion or even stiffness of the ankle joint, and development of degenerative changes. Larger studies with long-term results are still missing.

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Section: Resultsmentioning

confidence: 99%

Bosworth ankle fracture-dislocation: current concept review

Bartoníček,

Rammelt,

Tuček

2024

EFORT Open Reviews

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“…Our patient fits this pattern as a young adult with a dislocation of the fibula without a fracture. In addition, a recent literature review by Lucenti et al reports a 92.2% rate of unsuccessful closed reductions for Bosworth injuries and a 10.7% rate of post-traumatic arthritis; however, they did not include studies before 2002 [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

A rare Bosworth Variant Isolated Distal Fibula Dislocation with a Successful Closed Reduction: A Case Report and Technique

Snyder,

Mesko

2024

jocr

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Introduction: The Bosworth fracture-dislocation is a rare injury originally described as an irreducible dislocation of a distal fibula fracture where the proximal fibular fragment becomes incarcerated behind the distal tibia. There have since been a few cases described of an intact distal fibula with dislocation and similar difficulties in closed reduction attempts, typically seen with associated injuries to the ankle or proximal fibula. Regardless of the specific fracture or dislocation pattern, closed reduction attempts have consistently failed in the significant majority of these cases, which can lead to complications including soft-tissue compromise, severe post-traumatic arthritis, compartment syndrome, avascular necrosis of the talus, and neurovascular compromise. There is only one case in recent literature that describes an isolated distal fibula dislocation without associated fractures or dislocations of the lower extremity; however, it required an open reduction. Cases where a closed reduction was successful to achieve an anatomic reduction of a Bosworth-type injury are exceedingly rare. Case Report: We present a rare case of a purely ligamentous, isolated distal fibula dislocation in a 21-year-old male who underwent a successful closed reduction upon initial presentation and later underwent surgical fixation with a syndesmosis repair system. We describe the technique used for a successful closed reduction for this injury and present a 1-year follow-up with excellent outcomes. Conclusion: This is the only known case report of a successful closed reduction in an isolated distal fibula dislocation, as well as demonstrating a minimally invasive technique for definitive treatment with a syndesmosis repair system. Accurate diagnosis, early treatment, and anatomic reduction are imperative for good clinical outcomes and reducing complications for Bosworth injuries. This technique may improve the rates of successful closed reductions of Bosworth injuries upon initial presentation, leading to decreased complications and improved patient outcomes. Keywords: Bosworth, fibula dislocation, reduction technique, syndesmosis repair.

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Bosworth Fractures of the Ankle: A Systematic Literature Review

Cited by 2 publications

References 31 publications

Bosworth ankle fracture-dislocation: current concept review

Bosworth ankle fracture-dislocation: current concept review

A rare Bosworth Variant Isolated Distal Fibula Dislocation with a Successful Closed Reduction: A Case Report and Technique

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