Bosworth fracture

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Specialty	orthopedic
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The Bosworth fracture is a rare fracture of the distal fibula with an associated fixed posterior dislocation of the proximal fibular fragment which becomes trapped behind the posterior tibial tubercle. The injury is caused by severe external rotation of the ankle.<ref name="perry">Perry, CR,

 Posterior fracture-dislocation of the distal part of the fibula. Mechanism and staging of injury., 
 J Bone Joint Surg Am, 
 
 Vol. 65(Issue: 8),
 pp. 1149–57,
 DOI: 10.2106/00004623-198365080-00016,
 PMID: 6630259,
 
 
 Full text,</ref> The ankle remains externally rotated after the injury, making interpretation of X-rays difficult which can lead to misdiagnosis and incorrect treatment.<ref>Hoblitzell, RM, 
 Bosworth fracture-dislocation of the ankle. A case report and review of the literature., 
 Clin Orthop Relat Res, 
 1990,
 
 pp. 257–62,
 
 PMID: 2112075,</ref> The injury is most commonly treated by open reduction internal fixation as closed reduction is made difficult by the entrapment of the fibula behind the tibia.<ref name="perry" />

The entrapment of an intact fibula behind the tibia was described by Ashhurst and Bromer in 1922, who attributed the description of the mechanism of injury to Huguier's 1848 publication.<ref>Ashhurst, APC,

 Classification and Mechanism of Fractures of the Leg Bones Involving the Ankle. Based on a Study of Three Hundred Cases from the Episcopal Hospital., 
 Arch. Surg., 
 1922,
 Vol. 4,
 pp. 51–129,
 DOI: 10.1001/archsurg.1922.01110100060003,
 
 
 
 Full text,</ref> The injury involving fibular fracture with posterior dislocation was described by David M. Bosworth in 1947.<ref>Bosworth, DM, 
 Fracture-Dislocation of the Ankle with Fixed Displacement of the Fibula behind the Tibia., 
 J Bone Joint Surg, 
 
 Vol. 29,
 pp. 130–135,</ref>

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