Bosworth fracture-dislocation – a 13-year follow-up

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F61383082%3A_____%2F22%3A00001257" target="_blank" >RIV/61383082:_____/22:00001257 - isvavai.cz</a>

Alternative codes found

RIV/00216208:11110/22:10454704

Result on the web

<a href="https://www.sciencedirect.com/journal/fuss-and-sprunggelenk/vol/20/issue/4" target="_blank" >https://www.sciencedirect.com/journal/fuss-and-sprunggelenk/vol/20/issue/4</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1016/j.fuspru.2022.09.002" target="_blank" >10.1016/j.fuspru.2022.09.002</a>

Result language

angličtina

Original language name

Bosworth fracture-dislocation – a 13-year follow-up

Original language description

A 35-year-old man sustained a typical Bosworth fracture-dislocation (BF) with a displacement of the proximal fragment of the fibula behind the posterior sur face of the distal tibia, rupture of the deltoid ligament and separation of the posterior malleolus. Attempts at closed reduction failed. The surgery performed on the day of injury included reduction of the proximal fragment into the fibular notch, internal fixation of the distal fibula with a plate and a lag screw; the deltoid ligament and the posterior fragment of the distal tibia were not revised. Results: The wound healed and the fracture united without complications. The implants were removed 18 months postoperatively. At the follow-up 13 years after the injury, the patient had a slight limp and reported intermittent pain during weightbearing. Dorsifle xion and plantar flexion were reduced by little less than half as compared to the uninjured side. Radiograph and CT examination showed union in anatomical position without signs of posttraumatic arthritis. Overall, the final outcome was assessed as good. Conclusions: BF is a severe injury to the ankle that ist still frequently underestimated. Its typical features include marked deformation of the ankle, overlap of the distal tibia and fibula on the anteroposterior radiograph, tibiotalar subluxation and tibiofibular dissocia tion on the lateral radiograph. Computed tomography (CT) is indicated to identify all asso ciated lesions and determine the strategy of operative treatment, the success of which should be verified by postoperative CT in any case of doubt. Patients should be informed : A 35-year-old man sustained a typical Bosworth fracture-dislocation (BF) with a displacement of the proximal fragment of the fibula behind the posterior sur face of the distal tibia, rupture of the deltoid ligament and separation of the posterior malleolus. Attempts at closed reduction failed. The surgery performed on the day of injury included reduction of the proximal fragment into the fibular notch, internal fixation of the distal fibula with a plate and a lag screw; the deltoid ligament and the posterior fragment of the distal tibia were not revised. Results: The wound healed and the fracture united without complications. The implants were removed 18 months postoperatively. At the follow-up 13 years after the injury, the patient had a slight limp and reported intermittent pain during weightbearing. Dorsifle xion and plantar flexion were reduced by little less than half as compared to the uninjured side. Radiograph and CT examination showed union in anatomical position without signs of posttraumatic arthritis. Overall, the final outcome was assessed as good. Conclusions: BF is a severe injury to the ankle that ist still frequently underestimated. Its typical features include marked deformation of the ankle, overlap of the distal tibia and fibula on the anteroposterior radiograph, tibiotalar subluxation and tibiofibular dissocia tion on the lateral radiograph. Computed tomography (CT) is indicated to identify all asso ciated lesions and determine the strategy of operative treatment, the success of which should be verified by postoperative CT in any case of doubt. Patients should be informed about possible complications and long-term functional deficits. Repeated attempts on closed reduction should be avoided because they regularly fail and only increase the soft tissue strain.

Czech name

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Czech description

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Type

J_SC - Article in a specialist periodical, which is included in the SCOPUS database

CEP classification

—

OECD FORD branch

30211 - Orthopaedics

Project

<a href="/en/project/NU22-10-00240" target="_blank" >NU22-10-00240: Severe types of ankle fracture-dislocations (Maisonneuve and Bosworth fractures) - diagnostics, pathoanatomy, treatment, complications.</a><br>

Continuities

P - Projekt vyzkumu a vyvoje financovany z verejnych zdroju (s odkazem do CEP)

Publication year

2022

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

Fuß & Sprunggelenk

ISSN

1619-9987

e-ISSN

—

Volume of the periodical

20

Issue of the periodical within the volume

4

Country of publishing house

DE - GERMANY

Number of pages

6

Pages from-to

278 - 283

UT code for WoS article

—

EID of the result in the Scopus database

2-s2.0-85139299230