Total fibula dislocation: A rare variant of a Bosworth fracture-dislocation injury

Abstract

To our knowledge and from our review of the literature, this is a previously unreported variant of a Bosworth fracture - total fibula dislocation. A 45 year old male presented after a high energy external rotation injury to his lower leg and was diagnosed with a total fibula dislocation with the distal fibula dislocated and incarcerated posteriorly to the tibia. Definitive management was operative with fixation of the proximal tibiofibular joint and repair of the posterolateral corner structures as well as fixation distally of the syndesmosis injury. A graded rehabilitation programme was followed and 6 months postoperatively the patient was hill walking and jogging. Bosworth fracture-dislocations are rare injuries that can often be missed during the initial presentation, especially when there is no fracture associated with a dislocation. An underappreciation for the severity of this injury can have major sequelae and the clinician should have a high index of suspicion when diagnosing this injury. An appreciation for Bosworth fracture dislocations and their variations are important for the trauma surgeon.