Saraiva D, Pereira R, Sarmento A, Lemos R, Oliva X M
Servicio de Ortopedia y Traumatología, Centro Hospitalar Vila Nova de Gaia/Espinho, Porto, Portugal.
Departamento de Anatomía, Clínica del Remei, Universidad de Barcelona, Barcelona, España.
Acta Ortop Mex. 2016 Sep-Oct;30(5):251-255.
The Bosworth fracture is a pattern of fracture-dislocation of the ankle joint with fixed dislocation of the proximal part of the fibula behind the posterior malleolus. It is a rare injury, which requires high index of suspicion for diagnosis. Fixed dislocation of the fibula does not allow for closed reduction, so open reduction and fixation of fibula or tibia is required. We present a case report of a patient who suffered a Bosworth fracture, with associated medial malleolus fracture. She underwent surgical treatment with open reduction and internal fixation of the fibula and tibia. We also performed anterior arthroscopy of the ankle, to evaluate the tibiofibular syndesmosis, remove loose osteochondral fragments, and perform debridement and microfracture of unstable chondral lesions of the talus. One year after injury, she remains with occasional pain and a normal range of motion comparing to the contralateral ankle joint. Bosworth fracture is a serious and rare injury, which requires early diagnosis and urgent surgical treatment. Performing ankle arthroscopy in the acute treatment of the Bosworth fracture allows for diagnosis and treatment of associated intra-articular injuries, as well as assisting with adequate fracture reduction and evaluation of the tibiofibular syndesmosis stability.
博斯沃思骨折是一种踝关节骨折脱位类型，腓骨近端固定性脱位至后踝后方。这是一种罕见损伤，诊断时需要高度怀疑。腓骨的固定性脱位不允许闭合复位，因此需要对腓骨或胫骨进行切开复位内固定。我们报告一例博斯沃思骨折患者，同时伴有内踝骨折。她接受了腓骨和胫骨切开复位内固定手术治疗。我们还对踝关节进行了前路关节镜检查，以评估胫腓联合，清除游离的骨软骨碎片，并对距骨不稳定软骨损伤进行清创和微骨折治疗。受伤一年后，与对侧踝关节相比，她仍偶尔感到疼痛，活动范围正常。博斯沃思骨折是一种严重的罕见损伤，需要早期诊断和紧急手术治疗。在博斯沃思骨折的急性期进行踝关节镜检查，有助于诊断和治疗相关的关节内损伤，以及辅助骨折充分复位和评估胫腓联合稳定性。
