1. Common Fracture Eponyms
Christopher L. Graham, MS4, Oregon Health & Science University

2. Objectives Radiographic recognition of common fracture patterns
Overview of fracture mechanism and associated radiographic findings
Brief history/background information on source of fracture eponym

3. Fracture Eponym?

4. Colles Fracture
Generally results from fall on outstretched hand (FOOSH mechanism)
Transverse fracture of distal radius with dorsal displacement and angulation of distal fragment
50-60% of cases have associated ulnar styloid fracture
Results in “Dinner Fork” deformity

5. Colles Fracture - Background
Named after Abraham Colles ( ), an Irish surgeon and anatomist
Fracture accurately described by Colles in the Edinburgh Medical and Surgical Journal in 1814

6. Fracture Eponym?

7. Smith’s Fracture
Result of fall on flexed hand or backward fall on palm of outstretched hand
Transverse fracture of distal radius with volar displacement and angulation of distal fragment
AKA reversed Colles fracture
Results in “Garden Spade” deformity

8. Smith’s Fracture - Background
Named after Robert William Smith ( ), an Irish surgeon
In 1847, fracture first described by Smith in "A Treatise on Fractures in the Vicinity of Joints, and on Certain Forms of Accidents and Congenital Dislocations."

9. Fracture Eponym?

10. Monteggia’s Fracture
Most commonly results from fall on outstretched hand with forced pronation, or direct trauma to forearm
Fracture of proximal or middle third of ulna with dislocation of radial head (anterior or posterior)
Comprises 1-2% of all forearm fractures

11. Monteggia’s Fracture - Background
Named after Giovanni Battista Monteggia ( ), a surgeon and professor in Milan, Italy
He described this fracture pattern in the pre-Roentgen era based solely on history and physical examination findings
Interestingly, Monteggia acquired syphilis by cutting himself at autopsy

12. Fracture Eponym?

13. Galeazzi’s Fracture
Results from fall on outstretched hand with forearm in pronation. Rotation of body with hand fixed to ground causes hyperpronation and subsequent fracture
Fracture between middle and distal 1/3 of radius with associated disruption of distal radioulnar joint
Comprises 3-7% of all forearm fractures

14. Galeazzi’s Fracture - Background
Ricardo Galeazzi ( ), an Italian surgeon at the Instituto de Rachitici in Milan, described this fracture in 1935
Fracture synonymous with his name despite being originally described by Sir Astley Cooper in 1842

15. Fracture Eponym?

16. Bennett’s Fracture Dislocation
Results from axial blow directed against a partially flexed metacarpal (fist fight)
Intraarticular fracture/dislocation of the base of the first metacarpal
Volar fragment of metacarpal continues to articulate with trapezium
Most frequent thumb fx

17. Bennett’s Fracture - Background
Edward Hallaran Bennett ( ), an Irish surgeon, originally described fracture in 1882
Of interest, in college Bennett studied under Dr. Robert William Smith, and introduced antisepsis to Dublin

18. Fracture Eponym?

19. Jones Fracture
Results from laterally directed force on the forefoot during plantar flexion of the ankle
Fracture at base of fifth metatarsal located 1.5 – 3.0 cm distal to tuberosity (styloid process) of fifth metatarsal – patients often develop persistent nonunions
Avulsion fractures at tuberosity involving peroneus brevis tendon are more common (termed pseudo-Jones or tennis fracture) – better prognosis than Jones fracture

20. Jones Fracture - Background
Sir Robert Jones ( ), an English orthopaedic surgeon, first described fracture in 1902
Actually described his own fracture after injuring himself while dancing around a Maypole at a military garden party

21. Fracture Eponym?

22. Tillaux Fracture
Results from external rotation force with stress placed on anterior tibiofibular ligament
Salter Harris type III fracture involving avulsion of anterolateral tibial epiphysis via anterior tibiofibular ligament
Middle and medial portions of physis close first. This injury generally seen in older adolescents before lateral physis has closed.

23. Tillaux Fracture - Background
Sir Astley Cooper (at left) first described this fracture in 1822 (recall he also first described the Galeazzi fracture!)
In 1892, Paul Jules Tillaux ( ), a French surgeon, delineated the mechanism of this injury as an avulsion fracture

24. Fracture Eponym?

25. Maisonneuve Fracture
Results from external rotation force applied to the ankle with the foot in either supination or pronation
Spiral fracture of proximal 1/3 of fibula with associated syndesmotic ligament disruption and injury to the medial ankle structures (medial malleolus or deltoid ligament)
Originally described in 1840 by Jacques Gilles Maisonneuve (1809–1897)

26. Fracture Eponym?

27. Boxer’s Fracture Caused by striking a solid object with a closed fist
Metacarpal neck fracture of little finger with volar angulation of metacarpal head
Skilled boxers rarely suffer this fracture as they don’t use a “roundhouse” motion when punching – usually see fracture of index metacarpal in professional fighter

28. References
Canale. Campbell’s Operative Orthopaedics, 9th ed. Mosby 1998.
Chapman. Chapman’s Orthopaedic Surgery, 3rd ed. Lippencott 2001
Wiesel and Delahay. Principles of Orthopaedic Medicine and Surgery. W.B. Saunders Company 2001

29. South Sister and Green Lake
The End!
South Sister and Green Lake