The Bosworth fracture, a fixed posterior fracture-dislocation of the
distal part of the fibula due to external rotation of the supinated foot,
is a rare injury. In this report we review the literature, present two new
cases, and describe our cadaver studies, showing that the initial stages of
the injury are identical to those of a Maisonneuve fracture. The final
stages that are unique to this fracture-dislocation are the posterior
dislocation and fracture of the fibula and the fracture of the medial
malleolus or rupture of the deltoid ligament. The objectives of treatment
are reduction of the dislocation, repair and stabilization of the
tibiofibular syndesmosis, and restoration of the ankle mortise to its
anatomical position.