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

Kód výsledku v 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>

Nalezeny alternativní kódy

RIV/00216208:11110/22:10454704

Výsledek na webu

<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>

Jazyk výsledku

angličtina

Název v původním jazyce

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

Popis výsledku v původním jazyce

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.

Název v anglickém jazyce

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

Popis výsledku anglicky

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.

Druh

J_SC - Článek v periodiku v databázi SCOPUS

CEP obor

—

OECD FORD obor

30211 - Orthopaedics

Projekt

<a href="/cs/project/NU22-10-00240" target="_blank" >NU22-10-00240: Závažné typy luxačních zlomenin hlezna (Maisonneuveova a Bosworthova zlomenina) - Diagnostika, pathoanatomie, léčba, komplikace.</a><br>

Návaznosti

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

Rok uplatnění

2022

Kód důvěrnosti údajů

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

Název periodika

Fuß & Sprunggelenk

ISSN

1619-9987

e-ISSN

—

Svazek periodika

20

Číslo periodika v rámci svazku

4

Stát vydavatele periodika

DE - Spolková republika Německo

Počet stran výsledku

6

Strana od-do

278 - 283

Kód UT WoS článku

—

EID výsledku v databázi Scopus

2-s2.0-85139299230