scholarly journals Association of Bosworth, Pilon, and Open Talus Fractures: A Very Unusual Ankle Trauma

2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
Kevin Moerenhout ◽  
Georgios Gkagkalis ◽  
Rayan Baalbaki ◽  
Xavier Crevoisier
Keyword(s):  
Case Report ◽  
Fracture Dislocation ◽  
Tibial Tubercle ◽  
Medial Malleolus ◽  
Distal Fibula ◽  
Rare Lesion ◽  
Ankle Trauma ◽  
One Year ◽  
Medial Malleolus Fracture ◽  
Hindfoot Arthrodesis

Introduction. A Bosworth fracture-dislocation is a rare lesion resulting in a fixed dislocation of the distal fibula behind the posterior tibial tubercle. Only few cases have been reported showing an associated consequent fracture, namely, a pilon or a medial malleolus fracture. Case Report. We present a case report of a patient with an unusual combination of a Bosworth injury with a pilon fracture and an open multifragmentary talus fracture and our approach for open reduction and internal fixation. At one year postoperative, the patient developed an invalidating tibiotalar and subtalar arthrosis that eventually required an ankle-hindfoot arthrodesis. A Bosworth injury is an infrequent entity and is even rarer when associated with other fractures. Careful preoperative planning is necessary, as the combination of these fractures is a surgical challenge. Special care must be taken to preserve the neurovascular bundle. Discussion. The present case highlights a Bosworth injury involving a severity that has never been described before and suggests adding an eighth stage to the classification presented by Perry et al.

scholarly journals Rare Bosworth Fracture-Dislocation Variant of an Irreducible Distal Fibula Dislocation of the Ankle Without Fibula Fracture

2019 ◽  
Vol 4 (2) ◽  
pp. 247301141882090
Author(s):  
Png Wenxian ◽  
Kinjal Vidyut Mehta
Keyword(s):  
Emergency Department ◽  
Road Traffic ◽  
Ankle Instability ◽  
Fracture Dislocation ◽  
Medial Malleolus ◽  
Distal Fibula ◽  
Level Of Evidence ◽  
Anatomic Reduction ◽  
Medial Malleolus Fracture ◽  
High Index Of Suspicion

Background: Irreducible fracture-dislocations of the ankle are rare orthopedic emergencies that should not be missed. The Bosworth fracture-dislocation is a rare fracture where an incarcerated fibula fragment remains locked behind the posterior lateral tubercle of the tibia. We present a case describing a variation of a Bosworth injury, with a dislocation of an intact distal fibula with an associated medial malleolus fracture. Methods: Our patient is a 55-year old male who presented to the emergency department with a left ankle injury after being involved in a road traffic accident. Radiographs show a posterior dislocation of an intact distal fibula associated with a fracture of the medial malleolus and disruption of the ankle mortise. Results: An attempt to reduce the dislocation at the emergency department under sedation was unsuccessful. The patient was subsequently taken to the operating theatre for manipulation and reduction and application of an external fixator. Definitive fixation was performed successfully a week later. Conclusion: A high index of suspicion is critical for diagnosing a Bosworth fracture-dislocation, as this diagnosis is commonly missed. Early diagnosis and proper surgical anatomic reduction are important to prevent chronic ankle instability and evolution towards ankle arthritis. Level of Evidence: Level IV, case study.

scholarly journals Genu Recurvatum Deformity in a Child due to Salter Harris Type V Fracture of the Proximal Tibial Physis Treated with High Tibial Dome Osteotomy

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Theodoros Beslikas ◽  
Andreas Christodoulou ◽  
Anastasios Chytas ◽  
Ioannis Gigis ◽  
John Christoforidis
Keyword(s):  
Tibial Tubercle ◽  
Rare Injury ◽  
Dome Osteotomy ◽  
Genu Recurvatum ◽  
Clinical Instability ◽  
Rare Lesion ◽  
Salter Harris ◽  
One Year ◽  
Type V ◽  
Immature Skeleton

Salter-Harris type V fracture is a very rare injury in the immature skeleton. In most cases, it remains undiagnosed and untreated. We report a case of genu recurvatum deformity in a 15-year-old boy caused by a Salter-Harris type V fracture of the proximal tibial physis. The initial X-ray did not reveal fracture. One year after injury, genu recurvatum deformity was detected associated with significant restriction of knee flexion and limp length discrepancy (2 cm) as well as medial and posterior instability of the joint. Further imaging studies revealed anterior bone bridge of the proximal tibial physis. The deformity was treated with a high tibial dome osteotomy combined with a tibial tubercle osteotomy stabilized with malleolar screws and a cast. Two years after surgery, the patient gained functional knee mobility without clinical instability. Firstly, this case highlights the importance of early identification of this rare lesion (Salter-Harris type V fracture) and, secondly, provides an alternative method of treatment for genu recurvatum deformity.

scholarly journals An incalcitrant symptomatic paediatric closed tibial medial malleolus fracture (case report)

2017 ◽  
Vol 15 (3) ◽  
pp. 262-265
Author(s):  
T. Al-Sadek ◽  
F. Yu-Sing Chan ◽  
A. Al-Sadek3 ◽  
G. Dimitrov ◽  
K. Marinov
Keyword(s):  
Case Report ◽  
Medial Malleolus ◽  
Medial Malleolus Fracture

scholarly journals Physiotherapy Rehabilitation in Operated Case of Patellar Fracture and Medial Malleolus Fracture- A Case Report

2021 ◽  
pp. 266-270
Author(s):  
Sawari Bhagwatkar ◽  
Pratik Phansopkar ◽  
Neha Chitale
Keyword(s):  
Case Report ◽  
Traffic Accidents ◽  
Road Traffic ◽  
External Rotation ◽  
Clinical Findings ◽  
Medial Malleolus ◽  
Patellar Fracture ◽  
Medial Aspect ◽  
Lacerated Wound ◽  
Medial Malleolus Fracture

Introduction: Road traffic accidents (RTA) are responsible for a considerable amount of global death and morbidity, particularly in developing nations. 'Hidden pandemics,' such as mortality from RTA, often go unnoticed over the world.(1) These days traffic road accidents lead to many fractures included patellar fracture. Patellar fractures account for about 1% of all skeletal fractures and are most common in people between the ages of 20 and 50. 1–3 Men have nearly twice as many cases as women. Clinical Findings: On physical examination respiratory system, cardiovascular system and central nervous system are normal and on local examination of left lower limb demonstrate attitude of limb in hip and knee in extension and foot in external rotation and multiple abrasions are present over the knee and there were abrasion of 10*2cm present over medial aspect of great toe and abrasion of 5*2cm present over the postero-medial aspect of distal 3rd leg, lacerated wound on medial malleolus.In this case patient was on 8 week protocol for physiotherapy management. Discussion: In this case report we are discussing a case of 36 year old male with fracture of patella and medial malleolus managed with tension band wiring and nailing respectively. The primary goal of physiotherapy management was to prevent secondary complications and make the patient independent for which rehabilitation protocol was planned which included isometric exercises, dynamic quadriceps bed mobility exercises and ambulation. Conclusion: Physiotherapy plays an important role in rehabilitation of patient with medial malleolus and patella fracture.

scholarly journals Simultaneous traumatic dislocation of the hip knee and ankle joints in an ipsilateral limb, does it happen? A case report

2018 ◽  
Vol 5 (7) ◽  
pp. 2660
Author(s):  
Lokesh Kumar S. N. ◽  
Deepak Kumar ◽  
Sameer Aggarwal
Keyword(s):  
Ankle Joint ◽  
Hip Joint ◽  
Weight Bearing ◽  
Posterior Dislocation ◽  
Fracture Dislocation ◽  
Radiographic Examination ◽  
Medial Malleolus ◽  
Pilon Fracture ◽  
Medial Malleolus Fracture ◽  
Dislocation Of The Hip

Simultaneous dislocation of three joints the hip knee and ankle joint in an ipsilateral limb is a very rare pattern of injury and only a single case has been reported in the literature, but it is associated with acetabulum fracture. A 34-year-old male had met with a road traffic accident involving left lower limb. Radiographic examination revealed (i) Posterior dislocation of the hip joint without any fracture (ii) Posterior dislocation of the knee joint(iii)Open fracture dislocation of the ankle joint with medial malleolus fracture tibial pilon fracture. The patient underwent an immediate closed reduction of the hip joint by Allis method. Simultaneous reduction of the knee and ankle joint was done and appropriate splintage gave. Open wounds were well debrided and trans-articular fixator was placed over knee and ankle joint. At a second stage, the medial malleolus fracture and tibia pilon fracture were fixed. MRI scan was done which revealed an anterior cruciate ligament injury of the knee. At 6-month follow-up, the patient was ambulating with full weight-bearing on both lower extremities without any assistive devices. There always lies a high risk of hemodynamic instability and other serious and life-threatening injuries due to the high velocity of trauma involved in such cases. The outcome of ipsilateral hip knee and ankle dislocation can vary widely depending on the circumstances and other associated injuries.

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