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