Eponymous Fractures Name

Dr. Muhammad Bin Zulfiqar

PGR III FCPS Services Hospital Lahore / Services
Institute of Medical Science

Eponymous Fractures Name

Bankart fracture
Barton fracture.
Bennett fracture.
Busch fracture.
Chance fracture
Chopart fracture.
Colles fracture.
Cotton fracture.
De Quervain fracture
Dupuytren fracture
Duverney fracture.
Essex-Lopresti fracture

Eponymous Fractures Name

Galeazzi fracture.
Gosselin fracture.
Holdsworth fracture.
Hutchinson fracture.
Jefferson fracture
Jones fracture.
Le Fort fracture (maxilla).
Le Fort fracture (ankle).
Lisfranc fracture.
Maisonneuve fracture.

Eponymous Fractures Name

Malgaigne fracture.
Mason fracture
Pott fracture.
Rolando fracture.
Segond fracture.
Shepherd fracture.
Skillern fracture.
Smith fracture.
Tillaux fracture.

Eponymous Fractures Name

Hangmans fracture.
Boxers fracture.
Clay shovelers fracture.
Gamekeepers thumb.
Greenstick fracture.
Torus fracture.
March fracture.
Dancers fracture.

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.

 FIGURE A3-1
Bankart fracture is
better visualized
with
special techniques,
such as this CT
arthrography in
coronal (A) and
axial (B) views.

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.

Barton fracture. The fracture line reaches the

joint.

Bennett fracture.
A Bennett fracture involves fracturedislocation 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).

 FIGURE A3-3 Bennett fracture.

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 baseball finger because it occurs
frequently in baseball players.

Busch fracturedetachment with

detachment of a
fragment of the distal
phalanx of the finger
and the extensor
tendon.

Chance fracture.
This fracture is also referred to as seat belt
fracture 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).

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.

Chopart fracture.
A Chopart fracture consists of fracturedislocation of the midtarsal joints (i.e., the
tarsonavicular and calcaneocuboid joints).

 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.

Colles fracture.
This is possibly the most famous 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 Pouteau is used (Fig. A3-6).

A and B, An example of a classic Colles or

Pouteau fracture.

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).

 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.

De Quervain fracture.
The name De Quervain is applied to fractures
of the scaphoid associated with dislocation of
the semilunar bone (Fig. A3-8).

De Quervain fracture.

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).

Example of a Dupuytren fracture.

Duverney fracture.
A Duverney fracture involves the iliac wing
immediately below the anterior-superior iliac
spine, with no other concomitant fractures.

Duverny Fracture

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.

Essex Lopresti Fracture

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.

Galeazzi fracture.

Gosselin fracture.
A fracture having a V shape, Gosselin fracture
affects the distal tibia with intra-articular
extension.

Gosselin fracture.

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

Holdsworth fracture.
Holdsworth fracture is an unstable spinal
fracture at the thoracolumbar junction
affecting the vertebral body, articular
processes, and posterior ligaments.

Hutchinson fracture.
An oblique fracture of the radial styloid
process (Fig. A3-11), Hutchinson fracture is
also known as chauffeur fracture. At the
beginning of the past century it was often
caused by the kickback produced when
starting an automobile by hand-cranking.

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).

Jefferson fracture. Atlas fractures should be

assessed by CT.

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 fractureavulsion of the base of fifth metatarsal, known
as dancers fracture or pseudo-Jones
fracture, 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.

Jones fracture. Fracture of the base of the fifth

metatarsal.

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.

 Leforte II

Le Fort fracture (ankle).

The Le Fort ankle fracture is a vertical fracture
of the fibula with avulsion of the tibiofibular
ligament.

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).

Lisfranc fracture. This is an example of a

fracture of the second metatarsal base with
dislocation from the second to the third
metatarsal.

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. A315).

Maisonneuve fracture. Fracture of the proximal

third of the fibula and the medial malleolus.

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. A316).

 FIGURE A3-16 Malgaigne fracture. In this

image, fracture of the hemisacrum and both
right pubic rami can be observed

Mason fracture.
Mason fracture is an isolated fracture of the
radial head (Fig. A3-17).

 FIGURE A3-17 Mason fracture. This fracture

may manifest merely as a radial head
deformity.

Monteggia fracture.
Monteggia fracture is a proximal ulnar
fracture with anterior dislocation of the radial
head (Fig. A3-18).

 FIGURE A3-18 Lateral view of a Monteggia

fracture.

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).

 FIGURE A3-19 Pott

fracture. Fibular
fracture and
subluxation
of the talus due to
rupture of the deltoid
ligament.

Pipkin fracture
Impact to the knee with the hip flexed
(dashboard injury)Fracture of femoral head in
association with posterior dislocation of hip.

Pellegrini-Stieda disease Steida

fracture Pellegrinis 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

 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

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.

 FIGURE A3-20 Rolando fracture.

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).

 FIGURE A3-21
Segond fracture.
This fracture is
related with
insertion of the
tensor muscle
tendon of the
fascia lata.

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

 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 density 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).

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.

 FIGURE A3-22 Shepherd fracture. Subtle

fracture of the posterior talus.

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).

 FIGURE A3-23 Skillern fracture. This

association is not infrequent in children.

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. A324).

 FIGURE A3-24 Smith

fracture is the reverse
of a Colles fracture.

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).

FIGURE A3-25 Tillaux

fracture with a vertical
course.

Hangmans fracture.
Hangmans 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).

 FIGURE A3-26
Hangmans
fractures are
generally related
to traffic
accidents.

Boxers fracture.
As its name indicates, boxers 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.

 FIGURE A3-27
Boxers fracture.
This is one of the
most common
fractures and is
related to the
peaceful nature
of our society.

Clay Shovelers 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).

 Fracture of
spinous process of
C-6 vertebrae.

Gamekeepers thumb.
An injury that should now be called skiers
thumb, gamekeepers 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).

 Avulsed bone fragment is seen.

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).

 FIGURE A3-29 Greenstick

fracture of the cubitus.

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.

Torus fracture is often

diagnosed
during resolution of the
break, with visualization of
sclerosis.

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.

 FIGURE A3-31
March fracture.
Stress fracture of
the third
metatarsal.

Dancers fracture.
Fracture-avulsion of the base of fifth
metatarsal, known as dancers fracture,
occurs proximal to the tuberosity and is
related to the peroneus brevis tendon, also
known as pseudo Jones fracture (Fig. A3-32).

 FIGURE A3-32
Dancers fracture
(pseudo Jones
fracture). Fractureavulsion
of the base of fifth
metatarsal.

Lovers Fracture
Calcaneus is the most commonly fractured tarsal bone
A so-called lovers Fracture 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 Don Juan fracture)
Why is it called a Lovers fracture?
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
Frequently occur at the thoraco-lumbar junction at L1, L2,
T12 and T11

 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) .

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

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.

 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.

 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.

 The CT-images nicely display the fracture

through the growth plate and the epiphysis.

 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.

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.

 Type A: below level of

the ankle joint with
tibiofibular syndesmosis
intact; deltoid ligament
intact and medial
malleolus often fractured

 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.

 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