Common Fracture Eponyms
Christopher L. Graham, MS4, Oregon Health & Science
University
Objectives

Radiographic recognition of common fracture
patterns

Overview of fracture mechanism and associated
radiographic findings

Brief history/background information on
source of fracture eponym
Fracture Eponym?
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
Colles Fracture - Background


Named after Abraham
Colles (1773-1843), an
Irish surgeon and
anatomist
Fracture accurately
described by Colles in
the Edinburgh Medical
and Surgical Journal in
1814
Fracture Eponym?
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
Smith’s Fracture - Background

Named after Robert
William Smith (18071873), 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."
Fracture Eponym?
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
Monteggia’s Fracture - Background

Named after Giovanni
Battista Monteggia (17621815), 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
Fracture Eponym?
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
Galeazzi’s Fracture - Background

Ricardo Galeazzi (1866-1952), 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
Fracture Eponym?
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
Bennett’s Fracture - Background

Edward Hallaran Bennett
(1837-1907), an Irish
surgeon, originally
described fracture in
1882

Of interest, in college
Bennett studied under
Dr. Robert William
Smith, and introduced
antisepsis to Dublin
Fracture Eponym?
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
Jones Fracture - Background

Sir Robert Jones (1855-1933),
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
Fracture Eponym?
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.
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
(1834-1904), a French
surgeon, delineated the
mechanism of this injury as
an avulsion fracture
Fracture Eponym?
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)
Fracture Eponym?
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
References
1.
2.
3.
4.
5.
6.
7.
8.
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
www.emedicine.com
www.learningradiology.com
www.wheelessonline.com
www.whonamedit.com
www.worldortho.com
The End!
South Sister and Green Lake