Bosworth ankle dislocation fracture − current concept review
Authors:
J. Bartoníček 1; M. Tuček 1; J. Malík 2
Authors‘ workplace:
Klinika ortopedie, 1. lékařská fakulta Univerzity Karlovy a Ústřední vojenské nemocnice – Vojenská fakultní nemocnice Praha, Česká republika
1; Radiodiagnostické oddělení, Ústřední vojenská nemocnice – Vojenská fakultní nemocnice Praha, Česká republika
2
Published in:
Rozhl. Chir., 2023, roč. 102, č. 12, s. 444-452.
Category:
Review
doi:
https://doi.org/10.33699/PIS.2023.102.12.444–452
Overview
Bosworth fracture (BF) is a rare, but a severe injury to the ankle, characterized by displacement of a fragment of the fractured fibula (mostly of Weber B type) from the tibiofibular incisure to the posterior surface of the distal tibia. In 70% of cases, it is associated with a fracture of the posterior malleolus. This injury is not quite well known, with only 175 cases described in the literature to date. BF requires CT examination, including 3D reconstructions. Closed reduction almost always fails as there is an increased risk of compartment syndrome, mainly after repeated attempts at closed reduction. Therefore, operative treatment is indicated as a standard. The outcome of the operation should be always checked by postoperative CT examination.
Sources
1. Bosworth DM. Fracture-dislocation of the ankle with fixed displacement of the fibula behind the tibia. J Bone Joint Surg Am. 1947;29(1):130−135.
2. Simonovich Z. Fractura luxation de Bosworth. Bol Trab Soc Argent Orthop Traumatol. 1975;40:193−211.
3. Mayer PJ, Evarts CM. Fracture-dislocation of the ankle with posterior entrapment of the fibula behind the tibia. J Bone Joint Surg Am. 1978;60(3):320−324.
4. Bartoníček J, Rammelt S. History of Bosworth fracture-dislocations. FussSprungg. 2022;20(4):284−290. doi: 10.1016/j.fuspru. 2022.10.003.
5. O´Leary C, Ward FJ. A unique closed abduction-external rotation ankle fracture. J Trauma 1989;29(1):119−121. doi: 10.1097/00005373-198901000-00027.
6. Jehlička D, Bartoníček J, Ryšavý M. Bosworthova zlomenina hlezna (Kazuistika). Acta Chir Orthop Traumatol Cech. 2001;68(4):256−260.
7. Bartoníček J, Frič V, Svatoš F, et al. Bosworth- type fibular entrapment injuries of the ankle – The Bosworth lesion. A report of 6 cases and literature review. J Orthop Trauma 2007; 21(10):710−717. doi: 10.1097/BOT.0b013e31815affb7.
8. Bartoníček J, Kostlivý K, Rammelt S. Bosworth fracture. A report of two atypical cases and literature review of 108 cases. Fuss Sprungg. 2017;15(2):126−137. doi: 10.1016/j.fuspru.2017.02.002.
9. Cho BK, Choi SM, Shin YD. Prognostic factors for intermediate-term clinical outcomes following Bosworth fractures of the ankle joint. Foot Ankle Surg. 2019; 25(5):601−607. doi: 10.1016/j. fas.2018.05.005.
10. Won Y, Lee GS, Hwang JM, et al. Improved functional outcome after early reduction in Bosworth fracture-dislocation. Foot Ankle Surg. 2019;25(6):798−803. doi: 10.1016/j.fas.2018.10.007.
11. Jehlička D, Bartoníček J, Svatoš F, et al. Luxační zlomeniny hlezna u dospĕlých. I. část: Epidemiologické zhodnocení ročního souboru. Acta Chir Orthop Traumatol Cech. 2002; 69(4):243−247.
12. Peterson ND, Shah F, Narayan B. An unusual ankle injury: The Bosworth-pilon fracture. J Foot Ankle Surg. 2015; 54(4):751−753. doi: 10.1053/j.jfas. 2014. 09.016.
13. Cappuccio M, Leonetti D, Di Matteo B, et al. An uncommon case of irreducible ankle fracture-dislocation: the “bosworth- like” tibio-fibular fracture. Foot Ankle Surg. 2017; 23(1):e1-e4. doi: 10. 1016/j.fas.2016.07.001.
14. Hamilton WC. Traumatic disorders of the ankle. New York, Springer 1984: 41−42, 76−77.
15. Chan D, Jones D. Irreducible syndesmosis due to an entrapped posterior fragment. Injury 1995; 26(8):569−571. doi: 10.1016/0020-1383(95)00087-p.
16. He S, Zhu J. Ankle arthroscopy-assisted closed reduction in Bosworth fracture dislocation. SAGE Open Med Case Rep. 2020;8:2050313X20974525. doi: 10.1177/2050313X20974525.
17. Meyers MH. Fracture about the ankle joint with fixed displacement of the proximal fragment of the fibula behind the tibia. J Bone Joint Surg Am. 1957;39(2):441−444.
18. Kostlivý K, Bartoníček J, Rammelt S. Posterior malleolus fractures in Bosworth fracture dislocations. A combination not to be missed. Injury 2020;51(2):537−541. doi: 10.1016/j.injury.2019.10.088.
19. Bartoníček J, Rammelt S, Kostlivý K, et al. Anatomy and classification of the posterior tibial fragment in ankle fractures. Arch Orthop Trauma Surg. 2015;135(4):505−516. doi: 10.1007/s00402 -015-2171-4.
20. Kašper Š, Bartoníček J, Kostlivý K, et al. Maisonneuveho zlomenina. Rozhl Chir. 2020; 99(2):77−85. doi: 10.33699/PIS. 2020.99.2.77-85.
21. Bartoníček J, Fojtík P, Bunganičová E, et al. Maisonneuveova zlomenina hlezna. Rozhl Chir. 2023; 102(2):48−59. doi: 10.33699/PIS.2023.102.2.48-59.
22. Ren W, Hu YC, Lu JK. Rare variants of Bosworth fracture-dislocation: Bosworth fracture dislocation with medial malleolus adduction type fracture. Chin J Traumatol. 2019;22(2):120−124. doi: 10. 1016/j.cjtee.2018.12.001.
23. Martin-Somoza FJ, Picazo DR, Cabezuelo JAM, et al. Bosworth fracture. An atypical case of irreducible ankle fracture-dislocation. Trauma Case Rep. 2020;28:100322. doi: 10.1016/j.tcr.2020.100322.
24. Han SJ, Kim JH, Yang DB, et al. Bosworth- type fibular entrapment fracture of the ankle without dislocation: a rare case report and a review of the literature. Ann Transl Med. 2021;9(2):178. doi: 10.21037/atm-20-5112.
25. Žofka P, Bartoníček J, Rammelt S. Bosworth fracture-dislocation – a 13-year follow-up. FussSprungg 2022;20(4):278−283. doi: 10.1016/j.fuspru.2022.09.002.
26. Perry CR, Rice S, Rao A, et al. Posterior fracture-dislocation of the distal part of the fibula. Mechanism and staging of injury. J Bone Joint Surg Am. 1983; 65(8):1149−1157.
27. Delasotta LA, Hansen RH, Sands AK. Surgical management of the posterior fibula fracture dislocation: Case report. Foot Ankle Int. 2013;34(10):1443−1446. doi: 10.1177/1071100713494379.
28. Hoblitzell RM, Ebraheim NA, Merritt T, et l. Bosworth fracture-dislocation of the ankle. Clin Orthop Relat Res. 1990; 255:257−262.
29. Lui TH, Chan KB, Kong CC, et al. Ankle stiffness after Bosworth fracture dislocation of the ankle. Arch Orthop Trauma Surg. 2008;128(1):49−53. doi: 10.1007/ s00402-007-0352-5.
30. Schepers T, Hagenaars T, Hartog DD. An irreducible ankle fracture dislocation: The Bosworth injury. J Foot Ankle Surg. 2012;51(4):501−503. doi: 10.1053/j.jfas. 2012.04.011.
31. Saraiva D, Pereira R, Sarmento A, et al. Artroscopía del tobillo en el tratamiento de la fractura de Bosworth. Acta Orthop Mex. 2016;30(5):251−255.
32. Bartoníček J, Rammelt S, Kostlivý K. Bosworth fracture complicated by unrecognized compartment syndrome: a case report and review of the literature. Arch Orthop Trauma Surg. 2022; 142(7):1435−1441. doi: 10.1007/s00402- 021-03815-1.
33. Khan F, Borton D. A constant radiological sign in Bosworth´s fracture: “The axilla sign”. Foot Ankle Int. 2008;29(1):55−57. doi: 10.3113/FAI.2008.0055.
34. Fan J, Michelin RM, Jenkins R, et al. A novel technique for a successful closed reduction of a Bosworth fracture-dislocation of the ankle. Cureus 2020;12(1):e6632. doi: 10.7759/cureus.6632.
35. Fleming JL, Smith HO. Fracture-dislocation of the ankle with the fibula fixed behind the tibia. J Bone Joint Surg Am. 1954;36(3):556-8.
36. Ji WB, Xu YF, Lu Z. Case report: Bosworth fracture-dislocation managed by closed reduction and conservative treatment. Front Surg. 2022;8:788575. doi: 10.3389/ fsurg.2021.788575.
37. Choi SH, Hur JM, Hwang KT. Delayed peroneal neuropathy after Bosworth fracture dislocation of the ankle. J Am Podiatr Med Assoc. 2021; 111:Article_15. doi: 10.7547/20- 013.
38. Patel K, Davidson J, Walker R. Percutaneous threaded pin reduction of Bosworth fracture: a novel surgical technique. Ann R Coll Surg Engl. 2023;105(1):78−79. doi: 10.1308/rcsann.2021.0363.
39. Bartoníček J, Rammelt S. Locked fracture- dislocation of the fibula (Bosworth) with impaction of the posterior tibial rim. In: Rammelt S, Swords M, Dhillon MS, et al. (eds). Manual of fracture management − foot and ankle. Stuttgart, Thieme 2019:199−208.
40. Rammelt S, Bartoníček J, Kroker L. Pathoanatomy of the anterolateral tibial fragment in ankle fractures. J Bone Joint Surg Am. 2022;104(4):353−363. doi: 10.2106/ JBJS.21.00167.
41. Rammelt S, Bartoníček J, Kroker L, et al. Surgical fixation of quadrimalleolar fractures of the ankle. J Orthop Trauma 2021;35(6):e216−222. doi: 10.1097/ BOT.0000000000001915.
42. Fahey JJ, Schlenker LT, Stauffer RC. Fracture dislocation of the ankle with fixed displacement of the fibula behind the tibia. Am J Roentgenol Radium Ther Nucl Med. 1956;76(6):1102−113.
43. Downey MW, Motley TA, Kosmopoulos V. The Bosworth ankle fracture: A retrospective case series and literature review. EC Orthopaedics 2016:243−253.
44. Mata RMG. Fractura-luxación de Bosworth. Rev Asoc Arg Ortop Traumatol. 1997;62(4):471−479.
45. Ikuta T, Toihata T, Yonetake T. A case of fracture-dislocation of ankle with fibula fixed behind tibia (Bosworth fracture-dislocation). Orthopedics and Traumatology (Japan) 2004;53:328−331.
46. Hasler J, Antoniadis A, Gkagkalis G, et al. Irreponible Luxation des oberen Sprunggelenks: die Bosworth. Verletzung. Unfallchirurg 2019;122:992−996. doi: 10.1007/s00113-019-00725-1.
47. Hancock JB. Rare ankle fracture pattern: Bosworth fracture can lead to post-traumatic arthritis if unrecognized early. MOJ Orthop Rheumatol. 2015;2(1):14−17. doi: 10.15406/mojor.2015.02.00031.
48. Szalay Y, Roberts JB. Compartment syndrome after Bosworth fracture-dislocation of the ankle: A case report. J Orthop Trauma 2001;15(4):301−303. doi: 10.1097/00005131-200105000-00012.
49. Yeoh CSN, Tan GMJ. Bosworth fracture- dislocation of the ankle: a case report. J Orthop Surg 2013;21(2):249−252. doi: 10.1177/230949901302100228.
50. Zhu H, Yuan F, Fan J, et al. Effectiveness of open reduction and internal fixation for Bosworth fracture. [Article in Chinese]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2013;27(9):1054−1056.
51. Wang Z, Feng Q, Dai Y, et al. Bosworth fracture dislocation of the ankle: A case report and literature review. Research Square 2020. doi:10.21203/rs.3.rs-99420/v1.
Labels
Surgery Orthopaedics Trauma surgeryArticle was published in
Perspectives in Surgery
2023 Issue 12
Most read in this issue
- Robotic resection of the rectum – what are the advantages?
- Bosworth ankle dislocation fracture − current concept review
- Duodenal gastrinoma – case report
- The significance of glycocalyx in surgery