Common Fracture Eponyms Christopher L. Graham, MS4, Oregon Health & Science University.
-
Upload
harriet-hancock -
Category
Documents
-
view
319 -
download
9
Transcript of Common Fracture Eponyms Christopher L. Graham, MS4, Oregon Health & Science University.
Common Fracture Common Fracture EponymsEponyms
Christopher L. Graham, MS4, Oregon Health & Science University
ObjectivesObjectives
Radiographic recognition of common Radiographic recognition of common fracture patternsfracture patterns
Overview of fracture mechanism and Overview of fracture mechanism and associated radiographic findingsassociated radiographic findings
Brief history/background information Brief history/background information on source of fracture eponymon source of fracture eponym
Fracture Eponym?Fracture Eponym?
CollesColles FractureFracture Generally results from fall Generally results from fall
on outstretched hand on outstretched hand (FOOSH mechanism)(FOOSH mechanism)
Transverse fracture of Transverse fracture of distal radius with dorsal distal radius with dorsal displacement and displacement and angulation of distal angulation of distal fragmentfragment
50-60% of cases have 50-60% of cases have associated ulnar styloid associated ulnar styloid fracturefracture
Results in “Dinner Fork” Results in “Dinner Fork” deformitydeformity
Colles Fracture - Colles Fracture - BackgroundBackground
Named after Named after Abraham Colles Abraham Colles (1773-1843), an (1773-1843), an Irish surgeon and Irish surgeon and anatomistanatomist
Fracture accurately Fracture accurately described by Colles described by Colles in the Edinburgh in the Edinburgh Medical and Medical and Surgical Journal in Surgical Journal in 18141814
Fracture Eponym?Fracture Eponym?
Smith’s FractureSmith’s Fracture Result of fall on flexed Result of fall on flexed
hand or backward fall on hand or backward fall on palm of outstretched palm of outstretched handhand
Transverse fracture of Transverse fracture of distal radius with volar distal radius with volar displacement and displacement and angulation of distal angulation of distal fragmentfragment
AKA reversed Colles AKA reversed Colles fracturefracture
Results in “Garden Results in “Garden Spade” deformitySpade” deformity
Smith’s Fracture - Smith’s Fracture - BackgroundBackground
Named after Robert Named after Robert William Smith (1807-William Smith (1807-1873), an Irish surgeon1873), an Irish surgeon
In 1847, fracture first In 1847, fracture first described by Smith in described by Smith in "A Treatise on "A Treatise on Fractures in the Fractures in the Vicinity of Joints, and Vicinity of Joints, and on Certain Forms of on Certain Forms of Accidents and Accidents and Congenital Congenital Dislocations." Dislocations."
Fracture Eponym?Fracture Eponym?
Monteggia’s FractureMonteggia’s Fracture Most commonly results Most commonly results
from fall on outstretched from fall on outstretched hand with forced hand with forced pronation, or direct pronation, or direct trauma to forearmtrauma to forearm
Fracture of proximal or Fracture of proximal or middle third of ulna with middle third of ulna with dislocation of radial head dislocation of radial head (anterior or posterior)(anterior or posterior)
Comprises 1-2% of all Comprises 1-2% of all forearm fracturesforearm fractures
Monteggia’s Fracture - Monteggia’s Fracture - BackgroundBackground
Named after Giovanni Named after Giovanni Battista Monteggia Battista Monteggia (1762-1815), a surgeon (1762-1815), a surgeon and professor in Milan, and professor in Milan, ItalyItaly
He described this He described this fracture pattern in the fracture pattern in the pre-Roentgen era based pre-Roentgen era based solely on history and solely on history and physical examination physical examination findingsfindings
Interestingly, Monteggia Interestingly, Monteggia acquired syphilis by acquired syphilis by cutting himself at autopsycutting himself at autopsy
Fracture Eponym?Fracture Eponym?
Galeazzi’s FractureGaleazzi’s Fracture Results from fall on Results from fall on
outstretched hand with outstretched hand with forearm in pronation. forearm in pronation. Rotation of body with hand Rotation of body with hand fixed to ground causes fixed to ground causes hyperpronation and hyperpronation and subsequent fracturesubsequent fracture
Fracture between middle Fracture between middle and distal 1/3 of radius and distal 1/3 of radius with associated disruption with associated disruption of distal radioulnar jointof distal radioulnar joint
Comprises 3-7% of all Comprises 3-7% of all forearm fracturesforearm fractures
Galeazzi’s Fracture - Galeazzi’s Fracture - BackgroundBackground
Ricardo Galeazzi (1866-1952), an Italian surgeon at the Ricardo Galeazzi (1866-1952), an Italian surgeon at the Instituto de Rachitici in Milan, described this fracture Instituto de Rachitici in Milan, described this fracture in 1935in 1935
Fracture synonymous with his name despite being Fracture synonymous with his name despite being originally described by Sir Astley Cooper in 1842originally described by Sir Astley Cooper in 1842
Fracture Eponym?Fracture Eponym?
Bennett’s Fracture Bennett’s Fracture DislocationDislocation
Results from axial blow Results from axial blow directed against a directed against a partially flexed partially flexed metacarpal (fist fight)metacarpal (fist fight)
Intraarticular Intraarticular fracture/dislocation of fracture/dislocation of the base of the first the base of the first metacarpalmetacarpal
Volar fragment of Volar fragment of metacarpal continues to metacarpal continues to articulate with trapeziumarticulate with trapezium
Most frequent thumb fxMost frequent thumb fx
Bennett’s Fracture - Bennett’s Fracture - BackgroundBackground
Edward Hallaran Edward Hallaran Bennett (1837-1907), Bennett (1837-1907), an Irish surgeon, an Irish surgeon, originally described originally described fracture in 1882fracture in 1882
Of interest, in college Of interest, in college Bennett studied under Bennett studied under Dr. Robert William Dr. Robert William Smith, and introduced Smith, and introduced antisepsis to Dublinantisepsis to Dublin
Fracture Eponym?Fracture Eponym?
Jones FractureJones Fracture Results from laterally directed Results from laterally directed
force on the forefoot during force on the forefoot during plantar flexion of the ankleplantar flexion of the ankle
Fracture at base of fifth Fracture at base of fifth metatarsal located 1.5 – 3.0 metatarsal located 1.5 – 3.0 cm distal to tuberosity (styloid cm distal to tuberosity (styloid process) of fifth metatarsal – process) of fifth metatarsal – patients often develop patients often develop persistent nonunionspersistent nonunions
Avulsion fractures at Avulsion fractures at tuberosity involving peroneus tuberosity involving peroneus brevis tendon are more brevis tendon are more common (termed pseudo-Jones common (termed pseudo-Jones or tennis fracture) – better or tennis fracture) – better prognosis than Jones fractureprognosis than Jones fracture
Jones Fracture - Jones Fracture - BackgroundBackground
Sir Robert Jones (1855-Sir Robert Jones (1855-1933), an English 1933), an English orthopaedic surgeon, orthopaedic surgeon, first described fracture first described fracture in 1902in 1902
Actually described his Actually described his own fracture after own fracture after injuring himself while injuring himself while dancing around a dancing around a Maypole at a military Maypole at a military garden party garden party
Fracture Eponym?Fracture Eponym?
Tillaux FractureTillaux Fracture Results from external Results from external
rotation force with stress rotation force with stress placed on anterior placed on anterior tibiofibular ligamenttibiofibular ligament
Salter Harris type III Salter Harris type III fracture involving avulsion fracture involving avulsion of anterolateral tibial of anterolateral tibial epiphysis via anterior epiphysis via anterior tibiofibular ligamenttibiofibular ligament
Middle and medial portions Middle and medial portions of physis close first. This of physis close first. This injury generally seen in injury generally seen in older adolescents before older adolescents before lateral physis has closed.lateral physis has closed.
Tillaux Fracture - Tillaux Fracture - BackgroundBackground
Sir Astley Cooper (at Sir Astley Cooper (at left) first described this left) first described this fracture in 1822 (recall fracture in 1822 (recall he also first described he also first described the Galeazzi fracture!)the Galeazzi fracture!)
In 1892, Paul Jules In 1892, Paul Jules Tillaux (1834-1904), a Tillaux (1834-1904), a French surgeon, French surgeon, delineated the delineated the mechanism of this injury mechanism of this injury as an avulsion fractureas an avulsion fracture
Fracture Eponym?Fracture Eponym?
Maisonneuve FractureMaisonneuve Fracture Results from external Results from external
rotation force applied to the rotation force applied to the ankle with the foot in either ankle with the foot in either supination or pronationsupination or pronation
Spiral fracture of proximal Spiral fracture of proximal 1/3 of fibula with associated 1/3 of fibula with associated syndesmotic ligament syndesmotic ligament disruption and injury to the disruption and injury to the medial ankle structures medial ankle structures (medial malleolus or deltoid (medial malleolus or deltoid ligament) ligament)
Originally described in 1840 Originally described in 1840 by Jacques Gilles by Jacques Gilles Maisonneuve (1809–1897)Maisonneuve (1809–1897)
Fracture Eponym?Fracture Eponym?
Boxer’s FractureBoxer’s Fracture Caused by striking a solid Caused by striking a solid
object with a closed fistobject with a closed fist
Metacarpal neck fracture Metacarpal neck fracture of little finger with volar of little finger with volar angulation of metacarpal angulation of metacarpal headhead
Skilled boxers rarely Skilled boxers rarely suffer this fracture as suffer this fracture as they don’t use a they don’t use a “roundhouse” motion “roundhouse” motion when punching – usually when punching – usually see fracture of index see fracture of index metacarpal in metacarpal in professional fighterprofessional fighter
ReferencesReferences
1.1. Canale. Campbell’s Operative Orthopaedics, Canale. Campbell’s Operative Orthopaedics, 99thth ed. Mosby 1998. ed. Mosby 1998.
2.2. Chapman. Chapman’s Orthopaedic Surgery, 3Chapman. Chapman’s Orthopaedic Surgery, 3rdrd ed. Lippencott 2001ed. Lippencott 2001
3.3. Wiesel and Delahay. Principles of Orthopaedic Wiesel and Delahay. Principles of Orthopaedic Medicine and Surgery. W.B. Saunders Medicine and Surgery. W.B. Saunders Company 2001Company 2001
4.4. www.emedicine.comwww.emedicine.com5.5. www.learningradiology.comwww.learningradiology.com6.6. www.wheelessonline.comwww.wheelessonline.com7.7. www.whonamedit.comwww.whonamedit.com8.8. www.www.worldorthoworldortho.com.com
The End!The End!
South Sister and Green Lake