It is important for clinicians to be aware of eponymous fractures as they are commonly used and allow for a succinct description of sometimes complex injuries.
Eponymous: of, relating to, or being the person or thing for whom or which something is named.
Eponym fractures are named based on the first person to describe them (e.g. Holstein-Lewis) or by an activity (e.g. Chauffer's)
We will review the eponymous fractures of the upper extremity going from proximal to distal.
To start off, what is an eponym for the following lesion?
This is an example of a Hill-Sachs lesion.
These occur during anterior shoulder dislocation as the posterolateral humeral head impacts the anterior glenoid rim.
Larger lesions may engage the glenoid and require repair.
On the contrary, what is an eponym for this lesion?
This is an example of a Reverse Hill-Sachs lesion.
These occur during posterior shoulder dislocation as the anteromedial humeral head impacts against the posterior glenoid rim.
What is an eponym for this fracture?
This is an example of a Bony-Bankhart lesion
During anterior shoulder dislocation an injury to the anteroinferior labrum may occur, a Bankhart Lesion. An avulsion fracture of the anteroinferior glenoid may also occur, a Bony-Bankhart Lesion
These can lead to chronic instability
What is an eponym for the following fracture?
This is an example of a Holstein-Lewis Fracture.
A spiral fracture of the distal ⅓ humeral shaft. This fracture pattern is associated with an increased risk of radial nerve injury.
This patient has a comminuted fracture of the radial head and dislocation of the distal radioulnar joint.
What is an eponym for the following fracture?
This is an example of an Essex-Lopresti fracture-dislocation.
These injuries are rare and commonly missed initially (as high as 80%) and an isolated radial head fracture should prompt evaluation of the DRUJ.
What is an eponym for the following fracture?
This is an example of a Monteggia fracture-dislocation.
This is a fracture of the proximal ulnar shaft with dislocation of the radiocapitellar joint.
What is an eponym for the following fracture?
This is an example of a Galeazzi fracture-dislocation.
It is a fracture of the distal radial shaft with disruption of the DRUJ. Of note, DRUJ disruption may be subtle.
Radial fractures within 7.5 cm of the wrist are associated with higher rates of chronic instability.
What is an eponym for this fracture?
This is an example of a night-stick fracture.
It is an isolated ulnar shaft fracture secondary to direct trauma.
Now onto two of the most well-known eponym fractures, that are also very easily confused.
What are the eponymous names of the following fractures?
On the left, we have a Smith's Fracture.
These are extraarticular distal radius fractures with volar displacement.
On the right, we have a Colles' Fracture.
These are extraarticular distal radius fractures with dorsal displacement.
What are the eponymous names for the following fractures?
On the left, we have a Chauffer's fracture. This is a radial styloid fracture caused by impaction against the scaphoid.
On the right, we had a Die-punch fracture. This is an intra-articular fracture of the lunate fossa caused by axial loading through the lunate.
What is an eponym for the following fracture?
This is an example of a Volar Barton's Fracture.
These can involve either the volar or dorsal lip of the distal radius.
Some may refer to a Dorsal Bartons as a "Barton's fracture" and Volar Bartons as a "Reverse Barton's fracture.
What is an eponym of the following fracture?
This is an example of a Boxer's Fracture.
These occur when an untrained person strikes with a flexed wrist.
Professional fighters would most likely fracture their 2nd or 3rd metacarpal because they would strike with a neutral wrist.
What are the eponymous names of the following metacarpal base fractures?
On the left is a Bennett's Fracture. This fracture may be displaced by the abductor pollicis longus.
In the middle is a Rolando Fracture, a comminuted fracture of the 1st metacarpal base.
On the right is a Reverse or Baby Bennet Fracture, this may be displaced by the ECU.
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Most tibial pilon fractures result from high-energy axial loading through the talus.
They are also commonly referred to as Tibial Plafond fractures. The tibial plafond is the distal articular surface of the tibia, which gained the name from its French meaning, "ceiling".
The term tibial pilon was first used by Étienne Destot in 1911 to describe the interaction of the distal tibia and talus during axial loading.
Pilon is the French term for "pestle".
The term was later adopted as a term for vertical impaction fractures of the distal tibia.
The humeral shaft is defined as the area distal to the surgical neck and proximal to the epicondyles.
The commonality of fracture is:
Middle ⅓ > Proximal ⅓ > Distal ⅓ shaft
The deforming forces of humeral shaft fractures usually result in what type of deformity?
Due to the muscular pull of the deltoid on the proximal fragment and medial/superior pull on the distal fragment, humeral shaft fractures tend to develop varus angulation.
Humeral shaft fractures are forgiving, and modest angulation can be overcome by the shoulders' large ROM.
An in-depth review of intertrochanteric and subtrochanteric hip fractures.
If you're interested in orthopedics you won't want to miss this one!
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Basicervical femoral neck, intertrochanteric (IT), and subtrochanteric (ST) hip fractures are different from femoral neck fractures in that they are extracapsular.
Extracapsular fractures, unlike intracapsular femoral neck fx, have a low likelihood of blood supply disruption/AVN
Anatomy:
The calcar femorale is an extension of cortical bone from the proximal shaft to the posteromedial femoral neck. It aids in weight distribution from the hip to the proximal femoral shaft.
The subtrochanteric region extends 5 cm below the lesser trochanter.