Gosselin fracture

Gosselin fracture is a V-shaped fracture of the distal tibia that extends into the tibial plafond (the distal weight bearing surface) and the ankle joint. This fracture is named after Leon Athanese Gosselin, a French surgeon who first described it in 1855.

Etiology

Gosselin fractures are typically caused by high-energy trauma, such as a fall from a significant height or a motor vehicle accident. The mechanism of injury is usually axial loading or twisting of the lower extremity.

Clinical Presentation

Patients with a Gosselin fracture present with pain, swelling, and inability to bear weight on the affected extremity. There may also be visible deformity of the ankle joint. On physical examination, there may be tenderness over the distal tibia and decreased range of motion of the ankle joint due to pain.

Diagnosis

Diagnosis of a Gosselin fracture is made based on the patient's history, physical examination, and imaging studies. Radiographs of the ankle are the initial imaging study of choice. They can show the V-shaped fracture and any associated fractures of the fibula or other parts of the ankle. Computed tomography (CT) scan may be used for further characterization of the fracture and preoperative planning.

Treatment

Treatment of Gosselin fractures depends on the severity of the fracture and the patient's overall health status. Nonsurgical treatment options include immobilization with a cast or splint and non-weight bearing. Surgical treatment options include open reduction and internal fixation (ORIF) or external fixation. The goal of treatment is to restore the normal anatomy of the ankle joint and prevent long-term complications such as post-traumatic arthritis.

Prognosis

The prognosis for Gosselin fractures is variable and depends on the severity of the fracture, the quality of the surgical repair, and the patient's overall health status. Complications can include infection, nonunion or malunion of the fracture, and post-traumatic arthritis.

See Also

• Distal tibia fracture
• Ankle fracture
• Leon Athanese Gosselin

References

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