This document lists and briefly describes several eponymous fractures. Some of the fractures described include:
- Colles fracture - A distal radius fracture with dorsal displacement of the distal fragment.
- Jones fracture - A fracture of the base of the fifth metatarsal distal to the tuberosity.
- Segond fracture - A proximal tibial epiphysis fracture associated with anterior cruciate ligament rupture.
- Barton's fracture - A fracture of the articular surface of the radius with dorsal or ventral displacement.
The document provides brief 1-2 sentence descriptions of over 30 different eponymous fractures. It includes diagrams to illustrate some of the fracture patterns.
6. Bankart fracture.
⢠One of the most frequently used eponyms,
this refers to a fracture of the anteroinferior
portion of the glenoid labrum associated with
anterior dislocation of the humeral head,
which is the mechanism causing the break. It
is difficult to recognize a Bankart fracture on
plain radiographs, and sometimes it can only
be detected with the use of CT (Fig. A3-1) or
MRI.
7. ⢠â FIGURE A3-1
Bankart fracture is
better visualized
with
special techniques,
such as this CT
arthrography in
coronal (A) and
axial (B) views.
8.
9. Barton fracture.
⢠Barton fractures affect the articular surface of
the radius (Fig. A3-2) and are associated with
dorsal or ventral displacement of the bone
fragment with respect to the carpal bones.
The fracture is produced by a shearing
mechanism and often requires surgery, and it
is oriented in the coronal plane.
11. Bennett fracture.
⢠A Bennett fracture involves fracture-
dislocation at the base of the first metacarpal.
Because this is the insertion site of the
abductor pollicis longus, it is virtually
impossible to reduce it without surgery (Fig.
A3-3).
13. Busch fracture.
⢠A Busch fracture consists of fracture with
detachment of a fragment of the distal
phalanx of the finger and the extensor tendon,
which inserts at this site (Fig. A3-4). It is also
known as âbaseball fingerâ because it occurs
frequently in baseball players.
15. Chance fracture.
⢠This fracture is also referred to as âseat belt
fractureâ because it results from hyperflexion
while wearing a seatbelt across the waist.
Chance fractures generally affect the L1 or L2
vertebra and are characterized by a horizontal
fracture line that compromises the vertebral
body or the posterior elements or both. When
both structures are affected, the fracture is
extremely unstable and requires surgery (Fig.
A3-5).
16. The Chance fracture requires additional
assessment with MR (A and B). In this
example involvement of the
vertebral body and posterior elements is
evident, requiring urgent surgery.
17. Chopart fracture.
⢠A Chopart fracture consists of fracture-
dislocation of the midtarsal joints (i.e., the
tarsonavicular and calcaneocuboid joints).
18. ⢠Chopart's fracture
dislocation. Black arrow
points to talus which is
dislocated from navicular
(yellow arrow) at
talonavicular joint.
Calcaneus (blue arrow) is
dislocated from the cuboid
(red arrow), which is also
fractured. The dislocation is
at the calcaneocuboid joint.
This is an uncommon
dislocation.
The forefoot is usually
displaced medially rather
than laterally as in this case.
19. Colles fracture.
⢠This is possibly the most âfamousâ eponym but
also the one most poorly used. A Colles fracture
affects the distal radius without compromising
the joint and occurs with dorsal displacement of
the distal fragment and volar angulation (dinner
fork deformity). It is sometimes associated with
fracture of the ulnar styloid process. The lesion is
produced by a fall on an outstretched hand. In
France and French-speaking countries the
eponym âPouteauâ is used (Fig. A3-6).
20. A and B, An example of a classic Colles or
Pouteau fracture.
21. Cotton fracture.
⢠Also known as trimalleolar fracture of the
ankle, Cotton fracture affects both malleoli
and, additionally, produces a displaced
fracture from the posterior margin of the tibial
articular surface. The eponym is infrequently
used (Fig. A3-7).
22. ⢠â FIGURE A3-7 A and B, Cotton fracture. In
addition to the fractures of the lateral and
medial malleoli there is also a fracture of the
posterior tibia and subluxation.
23. De Quervain fracture.
⢠The name De Quervain is applied to fractures
of the scaphoid associated with dislocation of
the semilunar bone (Fig. A3-8).
25. Dupuytren fracture.
⢠A Dupuytren fracture affects the tibia above
the lateral malleolus, with rupture of the distal
tibiofibular ligaments and deltoid ligament.
There may be an associated fracture of the
medial malleolus and lateral displacement of
the talus (Fig. A3-9).
27. Duverney fracture.
⢠A Duverney fracture involves the iliac wing
immediately below the anterior-superior iliac
spine, with no other concomitant fractures.
29. Essex-Lopresti fracture.
⢠The name Essex-Lopresti refers to a fracture of
the radial head, usually producing several
fragments and displacement. In addition,
there is distal dislocation of the radioulnar
joint.
31. Galeazzi fracture.
⢠A Galeazzi fracture involves the radius, usually
the radial diaphysis, with dislocation of the
distal radioulnar joint (Fig. A3-10). Often the
dislocation is only evident on clinical
examination and cannot be recognized on
radiography.
35. Hill-Sachs lesion
⢠Impacted fracture of the posterolateral aspect
of the humeral head caused by impingement
of the head on the anterior edge of the
scapular glenoid during anterior dislocation of
the shoulder.Increased risk of recurrent
dislocations
36.
37. Holdsworth fracture.
⢠Holdsworth fracture is an unstable spinal
fracture at the thoracolumbar junction
affecting the vertebral body, articular
processes, and posterior ligaments.
38. Hutchinson fracture.
⢠An oblique fracture of the radial styloid
process (Fig. A3-11), Hutchinson fracture is
also known as âchauffeur fracture.â At the
beginning of the past century it was often
caused by the kickback produced when
starting an automobile by hand-cranking.
39.
40. Jefferson fracture.
⢠A complex fracture of the atlas, Jefferson
fracture usually affects both the anterior and
posterior arches as well as the lateral masses
(Fig. A3-12).
42. Jones fracture.
⢠The Jones fracture affects the base of the fifth
metatarsal distal to the tuberosity (Fig. A3-13).
It should not be confused with fracture-
avulsion of the base of fifth metatarsal, known
as âdancerâs fractureâ or âpseudo-Jones
fracture,â which occurs proximal to the
tuberosity and is related to the peroneus
brevis tendon. Jones fracture should also be
differentiated from a lack of fusion of the
ossification center.
44. Le Fort fracture (maxilla).
⢠There are three types of Le Fort maxillary
fractures. Type I is a bilateral horizontal
fracture of the upper maxilla. Type II has a
more vertical fracture line and can reach floor
of the orbit, nasal cavity, or hard palate. In
type III there is complete detachment of the
maxilla and one or more facial bones from the
remaining craniofacial skeleton.
46. Le Fort fracture (ankle).
⢠The Le Fort ankle fracture is a vertical fracture
of the fibula with avulsion of the tibiofibular
ligament.
47.
48. Lisfranc fracture.
⢠Lisfranc fracture is associated with dislocation of
the tarsometatarsal joints. The most frequent
type involves fracture of the base of the second
metatarsal (anatomically wedged between the
medial and lateral cuneiform bones) and
posterolateral dislocation of four or all five
metatarsals. In normal conditions the internal
margin of the second cuneiform and that of the
base of the second metatarsal should be aligned.
This injury is more frequent in neuropathic
conditions (e.g., diabetes) than after trauma (Fig.
A3-14).
49. Lisfranc fracture. This is an example of a
fracture of the second metatarsal base with
dislocation from the second to the third
metatarsal.
50. Maisonneuve fracture.
⢠The Maisonneuve fracture refers to a spiral
fracture of the proximal third of the fibula
with disruption of the distal tibiofibular
syndesmosis and interosseous membrane. It
can be associated with fracture of the medial
malleolus or deltoid ligament rupture (Fig. A3-
15).
52. Malgaigne fracture.
⢠The Malgaigne fracture involves both pubic
rami with sacroiliac dislocation or fracture of
the sacrum. The lateral fragment, which
contains the acetabulum, is unstable (Fig. A3-
16).
53. ⢠â FIGURE A3-16 Malgaigne fracture. In this
image, fracture of the hemisacrum and both
right pubic rami can be observed
57. ⢠â FIGURE A3-18 Lateral view of a Monteggia
fracture.
58.
59. Pott fracture.
⢠A bimalleolar fracture, Pott fracture was
originally described as a subluxation of the
ankle with fracture of the distal third of the
fibula and tearing of the medial ligaments of
the joint (Fig. A3-19).
60. ⢠â FIGURE A3-19 Pott
fracture. Fibular
fracture and
subluxation
of the talus due to
rupture of the deltoid
ligament.
61. Pipkin fracture
⢠Impact to the knee with the hip flexed
(dashboard injury)Fracture of femoral head in
association with posterior dislocation of hip.
62.
63. Pellegrini-Stieda disease Steida
fracture Pellegriniâs syndrome
⢠Ossification of the superior portion of the
medial collateral ligament of the knee Sequela
of an old injury (or injuries) to the medial
collateral ligament (MCL) of the knee
64. ⢠Ossification of the
superior portion of
the medial collateral
ligament of the knee
Sequela of an old
injury (or injuries) to
the medial collateral
ligament (MCL) of the
knee
65. Rolando fracture.
⢠A comminuted intra-articular fracture,
Rolando fracture affects the base of the first
metacarpal and is associated with dislocation
(Fig. A3-20). It is similar to a Bennett fracture.
67. Segond fracture.
⢠The name Segond fracture is applied to
fracture-detachment of the proximal tibial
epiphysis, almost always associated with
rupture of the anterior cruciate ligament (Fig.
A3-21).
68. ⢠FIGURE A3-21
Segond fracture.
This fracture is
related with
insertion of the
tensor muscle
tendon of the
fascia lata.
69. Reverse Segond Fracture
⢠Cortical avulsion of tibial insertion of deep
capsular component of medial collateral ligament
⢠Mechanism: external rotation +valgus stress
⢠May be associated with: midsubstance tear of
posterior cruciate ligament; avulsion of PCL from
posterior tibial plateau; tear of medial meniscus
⢠Elliptic bone fragment arising from medial aspect
of proximal tibia
70. ⢠Figure 2. Reverse Segond fracture. (a) Anteroposterior
radiograph of the right knee shows an elliptic bone fragment
(arrow) arising from the medial tibial plateau. (b) Coronal fast
spin-echo proton densityâ weighted MR image shows the
tiny bone fragment (white arrow), which represents an
avulsion of the deep capsular component of the medial
collateral ligament. Irregularity of the donor site from the
tibial cortex is also seen (black arrow).
71. Shepherd fracture.
⢠This is a fracture of the posterolateral process
of the talus (Fig. A3-22) and should not be
mistaken for a normal variant, the os
trigonum.
72. ⢠FIGURE A3-22 Shepherd fracture. Subtle
fracture of the posterior talus.
73. Skillern fracture.
⢠The Skillern fracture is a complete fracture of
the lower third of the radius with a greenstick
or torus fracture of the ulna (Fig. A3-23).
74. ⢠â FIGURE A3-23 Skillern fracture. This
association is not infrequent in children.
75. Smith fracture.
⢠An extra-articular fracture of the distal third of
the radius with volar (palmar) displacement of
the distal fragment, the Smith fracture can be
considered a reverse Colles fracture (Fig. A3-
24).
76. ⢠â FIGURE A3-24 Smith
fracture is the reverse
of a Colles fracture.
77. Tillaux fracture.
⢠A Tillaux fracture consists of fracture-avulsion
of the vertical course of the anterior tibial
tubercle at the insertion of the anterior
tibiofibular ligament. It is more common in
older adolescents, in whom the medial
portion of the distal tibial physis is already
closed but the lateral area remains open. It is
sometimes seen in adults (Fig. A3-25).
79. Hangmanâs fracture.
⢠Hangmanâs fracture consists of a fracture of
the posterior elements of C2 and anterior
displacement of the C2 vertebral body with
respect to the C3 body (Fig. A3-26).
80. ⢠â FIGURE A3-26
Hangmanâs
fractures are
generally related
to traffic
accidents.
81. Boxerâs fracture.
⢠As its name indicates, boxerâs fracture results
from an impact made with a closed fist (Fig.
A3-27). A fracture is produced at the neck of
the fifth metacarpal with volar angulation of
the distal fragment.
82. ⢠â FIGURE A3-27
Boxerâs fracture.
This is one of the
most common
fractures and is
related to the
âpeacefulâ nature
of our society.
83. Clay Shovelerâs Fracture.
⢠This term refers to a fracture of a lower
cervical spinous process due to traction by the
interspinous ligaments. These structures exert
considerable force on the spinous processes
when pulling up on a shovel and throwing the
contents over the shoulder. The lesion is now
more often a result of traffic accidents (Fig.
A3-28).
85. Gamekeeperâs thumb.
⢠An injury that should now be called âskierâs
thumb,â gamekeeperâs thumb consists of
fracture-dislocation of the ulnar aspect of the
base of the first phalanx associated with a
lesion of the ulnar collateral ligament of the
first metacarpophalangeal joint (Stener and
non-Stener lesion).
87. Greenstick fracture.
⢠A lesion observed in children, greenstick
fracture is related to the plasticity of the bone
at this stage of development and to the
strength of the periosteum. It predominantly
affects the bones of the forearm and is
characterized by the fact that one side of the
bone is fractured while the opposite side
remains intact (Fig. A3-29).
89. Torus fracture.
⢠Another type of incomplete fracture seen in
children, torus fracture usually affects the
distal radial diaphysis (Fig. A3-30). Its name is
derived from an architectural term given to a
part of the base of a Greek column.
90. Torus fracture is often
diagnosed
during resolution of the
break, with visualization of
sclerosis.
91. March fracture.
⢠The march fracture, which frequently occurs in
military recruits, consists of a diaphyseal fatigue
fracture, usually of the second or third
metatarsal, due to overload during repeated
impact of the forefoot on the ground while
walking. The radiologic features may not be
evident initially. After 1 week a radiolucent line
can be seen and, later, periosteal reaction (Fig.
A3-31). These fatigue fractures can also occur in
other bones, such as the pelvis, femoral neck,
tibia, fibula, or calcaneus, although they are
much less common at these sites.
92. ⢠â FIGURE A3-31
March fracture.
Stress fracture of
the third
metatarsal.
93. Dancerâs fracture.
⢠Fracture-avulsion of the base of fifth
metatarsal, known as âdancerâs fracture,â
occurs proximal to the tuberosity and is
related to the peroneus brevis tendon, also
known as pseudo Jones fracture (Fig. A3-32).
94. ⢠â FIGURE A3-32
Dancerâs fracture
(pseudo Jones
fracture). Fracture-
avulsion
of the base of fifth
metatarsal.
95. Lovers Fracture
⢠Calcaneus is the most commonly fractured tarsal bone
⢠A so-called âloverâs Fractureâ is an intra-articular
fracture produced by an axial loading force typically
produced by a leap from a height with person landing
on heels (also called a âDon Juanâ fracture)
â Why is it called a âLoverâs fracture?â
⢠Because it is the type of fracture that could presumably be caused
by a lover jumping out of the bedroom window to escape from a
surprised and enraged spouse
⢠Bilateral in up to 10%
⢠The same axial load is transmitted to the spine and
may produce associated burst fractures of the lumbar
or thoracic spine in up to 10% of patients
â Frequently occur at the thoraco-lumbar junction at L1, L2,
T12 and T11
96. ⢠Bilateral calcaneal fractures and fractures of
spine. There is a comminuted fracture of the left
calcaneus (white arrow); there is a comminuted
fracture of the left calcaneus (red arrow) with
flattening of Bohler's Angle to 0 degrees. A
sagittal reconstructed CT scan of the spine shows
compression fractures of the superior endplates
of T12 and L1 (yellow arrows) .
97. Salter Harris Fracture
⢠The Salter-Harris classification describes fractures that
involve the epiphyseal plate or growth plate.
The most common is type II, which accounts for 75%.
⢠Type I - transverse fracture through the growth plate or
physis
⢠Type II - fracture through the growth plate and the
metaphysis, sparing the epiphysis
⢠Type III - fracture through growth plate and epiphysis,
sparing the metaphysis
⢠Type IV - fracture through all three elements of the
bone, the growth plate, metaphysis, and epiphysis
⢠Type V - compression fracture of the growth plate
98.
99. ⢠Type I
⢠Type I Salter-Harris fractures tend to occur in younger children (5).
It is a transverse fracture through the cartilage of the growth plate or
physis.
⢠Often, x-rays of a child with a type I growth plate fracture will appear
normal.
⢠Most type I growth plate injuries are treated with a cast.
Healing of type I fractures tends to be rapid and complications are rare.
100. ⢠Type II
⢠A type II growth plate fracture starts across the growth plate, but
the fracture then continues up through the metaphysis.
This is the most common type of growth plate fracture, and tends
to occur in older children. Often type II growth plate fractures must
be repositioned under anesthesia, but healing is usually quick and
complications are uncommon.
101. ⢠Type III
⢠Type III is a fracture through the growth plate and
epiphysis sparing the metaphysis.
⢠A type III fracture also starts through the growth
plate
⢠The fracture through the growth plate is only
seen on CT.
Continue with the CT images.
102. ⢠The CT-images nicely display the fracture
through the growth plate and the epiphysis.
103. ⢠Type IV
⢠Type IV is a fracture through all three elements of the
bone, the growth plate, metaphysis and epiphysis.
Notice that the epiphyseal fracture is in the sagittal
plane, the fracture through the growth plate is in the
axial plane and the metaphyseal fracture is in the
coronal plane.
These fractures are also named triplane fractures.
These are discussed in the next chapter.
104. Weber Classification Danis-Weber
Classification
⢠The Weber ankle fracture
classification (sometimes Danis-Weber) is a
simple system for classification of lateral
malleolar fractures, relating to the level of the
fracture in relation to the ankle joint.
105.
106. ⢠Type A: below level of
the ankle joint with
tibiofibular syndesmosis
intact; deltoid ligament
intact and medial
malleolus often fractured
107. ⢠Type B: at the level of
the ankle joint,
extending superiorly
and laterally up the
fibula. Tibiofibular
syndesmosis intact or
partially torn, but no
widening of the distal
tibiofibular
articulation. Medial
malleolus may be
fractured or deltoid
ligament my be torn.
108. ⢠Type C: above the level of the ankle joint.
Tibiofibular syndesmosis disrupted with widening
of the distal tibiofibular articulation. Medial
malleolus fracture or deltoid ligament injury
present