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Bosworth fracture complicated by unrecognized compartment syndrome: a case report and review of the literature

INTRODUCTION: Compartment syndrome (CS) is exceedingly rare in ankle fractures. However, the risk of CS development seems to be increased in the presence of a Bosworth fracture-dislocation (BF), a rare variant of locked dislocation of the fibula behind the tibia. MATERIALS AND METHODS: Here, we repo...

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Autores principales: Bartoníček, Jan, Rammelt, Stefan, Kostlivý, Karel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9217834/
https://www.ncbi.nlm.nih.gov/pubmed/33598758
http://dx.doi.org/10.1007/s00402-021-03815-1
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author Bartoníček, Jan
Rammelt, Stefan
Kostlivý, Karel
author_facet Bartoníček, Jan
Rammelt, Stefan
Kostlivý, Karel
author_sort Bartoníček, Jan
collection PubMed
description INTRODUCTION: Compartment syndrome (CS) is exceedingly rare in ankle fractures. However, the risk of CS development seems to be increased in the presence of a Bosworth fracture-dislocation (BF), a rare variant of locked dislocation of the fibula behind the tibia. MATERIALS AND METHODS: Here, we report the case of a 39-year old man with delayed diagnosis of CS after having sustained a BF and failed attempts on closed reduction. The patient developed a flexion contracture of the hallux necessitating secondary fusion. RESULTS: At 3 years after the injury, the patient was capable of running, but had 10 degrees limitation of ankle dorsiflexion, persisting decreased sensation on the plantar surface and clawing of the lesser toes. A thorough review of the literature revealed nine cases of CS after 167 reported BF resulting in a calculated prevalence of 5.4%. CONCLUSIONS: Given the extreme paucity of CS in malleolar fractures, CS in BF has a relatively high prevalence. Risk factors include severe dislocations, repeated attempts on closed reduction, and a long interval to definite surgery. A high index of suspicion is required because delayed diagnosis leads to lasting functional restrictions.
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spelling pubmed-92178342022-06-24 Bosworth fracture complicated by unrecognized compartment syndrome: a case report and review of the literature Bartoníček, Jan Rammelt, Stefan Kostlivý, Karel Arch Orthop Trauma Surg Trauma Surgery INTRODUCTION: Compartment syndrome (CS) is exceedingly rare in ankle fractures. However, the risk of CS development seems to be increased in the presence of a Bosworth fracture-dislocation (BF), a rare variant of locked dislocation of the fibula behind the tibia. MATERIALS AND METHODS: Here, we report the case of a 39-year old man with delayed diagnosis of CS after having sustained a BF and failed attempts on closed reduction. The patient developed a flexion contracture of the hallux necessitating secondary fusion. RESULTS: At 3 years after the injury, the patient was capable of running, but had 10 degrees limitation of ankle dorsiflexion, persisting decreased sensation on the plantar surface and clawing of the lesser toes. A thorough review of the literature revealed nine cases of CS after 167 reported BF resulting in a calculated prevalence of 5.4%. CONCLUSIONS: Given the extreme paucity of CS in malleolar fractures, CS in BF has a relatively high prevalence. Risk factors include severe dislocations, repeated attempts on closed reduction, and a long interval to definite surgery. A high index of suspicion is required because delayed diagnosis leads to lasting functional restrictions. Springer Berlin Heidelberg 2021-02-17 2022 /pmc/articles/PMC9217834/ /pubmed/33598758 http://dx.doi.org/10.1007/s00402-021-03815-1 Text en © The Author(s) 2021, corrected publication 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Trauma Surgery
Bartoníček, Jan
Rammelt, Stefan
Kostlivý, Karel
Bosworth fracture complicated by unrecognized compartment syndrome: a case report and review of the literature
title Bosworth fracture complicated by unrecognized compartment syndrome: a case report and review of the literature
title_full Bosworth fracture complicated by unrecognized compartment syndrome: a case report and review of the literature
title_fullStr Bosworth fracture complicated by unrecognized compartment syndrome: a case report and review of the literature
title_full_unstemmed Bosworth fracture complicated by unrecognized compartment syndrome: a case report and review of the literature
title_short Bosworth fracture complicated by unrecognized compartment syndrome: a case report and review of the literature
title_sort bosworth fracture complicated by unrecognized compartment syndrome: a case report and review of the literature
topic Trauma Surgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9217834/
https://www.ncbi.nlm.nih.gov/pubmed/33598758
http://dx.doi.org/10.1007/s00402-021-03815-1
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