This study details a rare instance of a high fibula fracture,classified as a Bosworth fracture.A 54-year-old male presented with pain and restricted movement in his right ankle after a sprain that occurred 10 hours ago.After initial assess-ments he was diagnosed as a right ankle fracture with posterior dislocation,a proximal right fibula fracture,and an injury to the right lower tibiofibular joint.According to Lauge-Hansen classification this was a type IV injury charactered by pronation-external rotation.Attempts at manual reduction were unsuccessful.Further evaluation using CT scans with three-dimensional reconstruc-tion showed a separation and dislocation at the lower tibiofibular joint,with the distal fibula interlocked with the posterolateral tib-ia.Additionally,comminuted fractures of the medial and posterior malleoli showed significant displacement and misalignment,leading to persistent ankle dislocation.Immediate calcaneal traction and symptomatic treatment were applied.On the third day of admission a reevaluation indicated successful reduction of the dislocated ankle and tibiofibular joint.Surgery was then performed with favorable outcome.Follow-up X-rays at one and a half years after surgery demonstrated bony heal of the fractures with normal ankle joint space and functionality.Bosworth fractures involving pronation-external rotation are notably less common than those with posterior-external rotation.When manual reduction proves ineffective,applying continuous calcaneal traction with gradual tension can help unlock fibular dislocation,thereby expediting surgical intervention.
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