Orthopedic Eponyms
Name
Bankhart’s
fracture
Barton’s
fracture
Bennett’s
fracture
Boxer’s fracture
Lesion
Anterior or posterior glenoid
rim fractures from impaction of
humeral head during shoulder
dislocation.
Displaced articular lip fracture
of the distal radius. Fracture
configuration may be dorsal or
volar direction.
Intra-articular
fracture/dislocation of base of
first metacarpal. Volar fragment
of metacarpal articulates with
trapezium.
5th metacarpal neck fracture
with volar angulation of
metacarpal head.
Chance fracture
Compression injury to the
anterior portion of the vertebral
body and a transverse fracture
through the posterior elements
of the vertebra and the
posterior portion of the
vertebral body
Chauffeur’s
fracture
Clay-Shoveler’s
fracture
Oblique intra-articular fracture
of radial styloid.
Spinous process fracture of the
lower cervical or upper thoracic
vertebrae.
Transverse fracture of distal
radius with dorsal displacement
and angulation of distal
fragment
Colles’ fracture
CRMTOL –
elbow
ossification
centres
Essex-Lopresti’s
fracture
Galeazzi’s
fracture
Gamekeeper’s
thumb (Skier’s)
Capitellum – 3months
Radial head – 4.5 years
Medial epicondyle – 5years
Trochlea – 8 years
Lateral epicondyle – 10 years
Fracture of radial head with
associated dislocation of distal
radio-ulnar joint.
Fracture between middle and
distal 3rd of radius with
associated disruption of distal
radioulnar joint.
Ulnar collateral ligament
rupture + avulsion fracture of
proximal phalanx of thumb
Significance
Site of lesion dependent on type of shoulder dislocation.
More common than Hill-Sack but less visualized as may
be purely cartilaginous.
May be associated with carpal subluxation. Arthritis of
wrist common. Mostly unstable needing early surgery in
young patients.
Axial blow against partially flexed metacarpal. ‘Fistfight’. Most frequent thumb fracture. Significant
angulation/shortening may need surgical correction.
Punching injury
>30˚ angulation, overlap of fingers during fist, significant
shortening indications for surgery. Watch out for bite
injuries and infection risk.
Caused by violent forward flexion. Most common site
T12-L1 and mid-lumbar region in lids. Common
mechanism – ‘seat-belt’ injury. More commonly if only
lap belt used. Reduced risk with shoulder and lap belt
use. Up to 50% of Chance fractures have associated
intra-abdominal injuries. Injuries associated with Chance
fractures include fractures of the pancreas; contusions
or lacerations of the duodenum; and mesenteric
contusions or lacerations.
Associated carpal instability likely +long-term arthritis.
Orthopedic review ± ORIF.
Commonest at C-7-T1, forced flexion injury – usually
stable but need full c-spine lateral x-ray for satisfactory
visualization
FOOSH mechanism, 50-60% associated ulnar styloid
fracture. Dinner-fork deformity → six classical lesions –
anterior angulation, dorsal displacement and impaction,
radial displacement/tilt, ulnar angulation and ulnar
styloid fractures. Closed reduction successful in 87% but
failure during cast application.
Anterior fat pad sign sometimes normal, but posterior
always pathologic. Posterior FP sign 30-70% c/o
pediatric elbow injuries. 70-90% times only finding.
Always look at wrist in case of radial head fractures with
FOOSH. Disruption of interosseous membrane.
FOOSH with hyperpronation. 3-7% of all forearm
fractures. All Galeazzi’s require ORIF.
Abduction injury with MCP joint instability.
Garden’s
classification
Hangman’s
fracture
Hawkin’s
classification
Hill-Sach’s
fracture
Femoral neck fractures
Type I – incomplete,
Undisplaced
Type II – Undisplaced complete
– unstable
Type III – complete with partial
displacement, rotation of neck
Type IV – complete subcapital
fracture with significant
displacement of fragments
Bilateral fractures through the
pedicles of C2
Talar neck # classification
Type I – non-displaced, fracture
line between middle and
posterior facets
Type II – any degree of subtalar
subluxation
Type III – displaced talar neck
fractures with dislocation of
both subtalar and ankle joints
Wedge defect of posterolateral
aspect of humeral head due to
impaction associated with
shoulder dislocation
Only type I can be managed conservatively
All others 35% risk of AVN, 57% risk of non-union.
Mortality 14-36% within 1 year of injury. 3X risk if
institutionalized prior to injury.
Hyperextension injury due to hanging. Fractures >25%
loss of height and retropulsion → unstable. Need
traction. Due to largest spinal canal many are stable.
Type I <30% risk AVN
Type II >30% risk AVN
Type III >90% AVN risk
Commonly associated inuries – vertebral compression
fracture, calcaneal fracture and medial malleolar
fractures.
Associated with infra-glenoid dislocation. ‘Lesion over
the hill’ from impact on glenoid rim.
Jefferson’s
fracture
Burst fracture of ring of C1
Axial loading from occipital condyles to superior
articular surfaces of lateral masses of C1. Typical
odontoid view. >6.9mm displacement associated with
transverse ligament disruption → unstable due to risk of
dens subluxation into cord.
Jones’ fracture
Fracture at base of fifth MT
located 1.5-3.0 cm distal to
tuberosity of the 5th MT.
Laterally directed force on the forefoot during plantar
flexion of ankle. Often develop non-union. PseudoJones’s fractures due to avulsion of tuberosity by
peroneus brevis more common with better prognosis.
ORIF for jones’ fracture – may need CT.
Legg-CalvéPerthes
syndrome
Idiopathic avascular
osteonecrosis of capital femoral
epiphysis of femoral head →
interruption of blood supply of
head of femur
Limp, hip/knee pain in age 4-6yrs, boys 4:1, x-ray
findings only in established cases → flattened and later
fragmented head of femur
Management – non-weight bearing,
orthotics/traction/braces/ physiotherapy.
Lisfranc’s
fracture
dislocation
Disruption of Lisfranc joint
(articulation between 5 TMT
joints) and/or Lisfranc ligament
(lateral margin of medial
cuneiform and medial plantar
surface of 2nd MT base.
>2mm separation of 1st and 2nd
MT, misalignment of 1st MT
with superior border of medial
cuneiform on lateral view. Fleck
sign in 90% cases → avulsion
Direct blows, sports-related injury. High-energy injuries
associated with MT fractures, cuneiform instabilities and
cuboid fractures. CT scan indicated for most injuries.
Potentially career-ending for sportsmen.
fracture from 2nd MT or medial
cuneiform.
Maisonneuve
fracture
Spiral fracture of proximal 1/3rd
of fibula with associated
syndesmotic ligament
disruption + injury to medial
ankle structures (mediall
malleolus or deltoid ligament)
External rotation force applied to ankle with foot in
supination or pronation.
Unstable fracture – reduce in ED + orthopedic consult
Mallet finger
Flexion deformity of DIP caused
by separation of extensor
tendon from distal phalanx.
Deformity due to direct injury to extensor tendon or
avulsion fracture from extensor insertion due to sudden
flexion
Monteggia’s
fracture
Fracture of proximal or middle
third of ulna with dislocation of
radial head (anterior or
posterior)
FOOSH with forced pronation or direct trauma to
forearm. Always look for other injury when one present.
1-2% of forearm fractures. Posterior interosseous nerve
injury common. All need ORIF.
Neer’s fracture
classification
Proximal humeral fractures
One-part -80%-non-displaced
Two-part-10%, one-part
significantly displaced
Three-,four-part – 10% two or
more significantly displaced
fragments
One-part → collar and cuff
Two-part → closed reduction/ age ORIF if
neurovascular/rotator cuff injury
Three-/four-part → ORIF superior as non-union likely
OsgoodSchlatter
disease
Tibial tubercle apophyseal
traction injury → rupture of
growth plate at tibial tuberosity
Age 6-9years, males 3:1, knee pain on
running/squatting. Bilateral 20-30%. Self-limiting →
rest/ice/compression/elevation.
Ottawa foot
and ankle rules
Laterally: tenderness over
posterior aspect of fibula 5cm
above joint, tenderness over
base of fifth MT.
Medially: posterior edge of
medial malleolus up to 5cm
above. Tenderness over
navicular. inability to wt. bear 4
steps in ED.
98% sensitive and 30% specific to rule out fractures in
adults and children. 50% reduction in use of x-rays.
Ottawa Knee
rules
Age>55, isolated patella
tenderness, tenderness at head
of fibula, inability to flex knee to
90˚, inability to wt bear 4 steps
at site/ED.
Sensitivity 97% specificity 27%, reduces x-ray use by
28%. May be used for children down to 5 years of age.
Pittsburgh knee
rules
Blunt injury or fall, age <12 or
>50, inability to wt bear 4 steps
in ED.
Sensitivity 99%, specificity 60%. Reduces x-ray use by
52%.
Pott’s fracture
Fracture of fibula 2-3 inches
above the lateral malleolus with
rupture of the deltoid ligament
and lateral displacement of the
talus.
Closed reduction in ED. Unstable ankle due to associated
ligament disruption.
Rheumatoid
arthritis –
hands
deformities
1. Fingers –
Boutonniere
2. Finger –
Swan-neck
3. Flexor
tenosynovitis
4. MCP joints
5. Wrists
Salter-Harris
classification
1. Type I – S =
same /straight
across
2. Type II – A =
Above
3. Type III – L =
Lower
4. Type IV – T =
Through
5. Type V – R =
Rammed
1. Non-reducible flexion at PIP
along with hyperextension at
DIP (50% patients with RA)
2. PIP hyperextension with
concurrent DIP flexion (50%)
3. Trigger fingers
4. Volar subluxation and ulnar
deviation
5. Disruption of radiolulnar jt,
dorsal subluxation of ulna
+rotation of carpus.
Arthritis mutilans – end result → opera glass hands.
Ulnar drift and carpal rotation causing zigzag deformity.
1. Transverse # through
hypertrophic zone
2. Fracture above the physis –
metaphyseal
3. Growth plate and extension
lower into epiphysis
4. Through metaphysis,
growth plate and epiphysis
5. Crushing physes injury
1. Growth disturbance uncommon -6% incidence
2. Most common – 75% incidence. Epiphysis not
involved
3. Spares metaphysis – 8% incidence.
4. Growth disturbance likely, 10% incidence
5. May appear as decreased physes height, may need
comparison with other side, growth disturbance >30%,
most missed injury, but only 1% incidence.
Schatzker
classification
Tibial plateau #
Type I, II, III – lateral tibial
plateau fracture with ↑articular
depression
Type IV – medial plateau
Type V and VI – both plateaus
with ↑ comminution and
instability
Lateral tibial plateau associated with ACxL and MCL
tears.
Medial tibial plateau associated with PCxL and LCL tears.
ORIF if significant comminution
Segond fracture
Tibial plateau avulsion fracture
at lateral capsular ligament
insertion
Excessive internal rotation and varus stress on fixed
knee. ACL disruption and rotatory instability common.
Slipped capital
femoral
epiphysis (SCFE)
Slippage of fractured physis
over metaphysis. Disrupted
Southwick angle. Limited hip
motion, particularly internal
rotation. Ice-cream cone
melting on x-ray.
Obese prepubescent males, hip/knee pain. 10-17yrs of
age. 20% cases bilateral. Pain onset 3-4months before xray evidence. 20-50% missed on initial presentation.
Need AP/lateral/frog-leg views. 25% AVN risk. SH type I
injury.
Smith’s fracture
Transverse fracture of distal
radius with volar displacement
and angulation of distal
fragment – ‘reverse Colles
fracture’.
Garden spade deformity. Fall on flexed hand or
backward FOOSH. Closed reduction to achieve radial
length.
Teardrop
fracture
Terry-Thomas
sign
Tillaux fracture
Weber
Classification
Young and
Burgess
classification
Fracture/dislocation of the
cervical spine with associated
triangular anterior fragment of
the involved vertebrae
↑scapholunate space >4mm
May be associated with extension or flexion injury.
Ligamentous disruption of flava makes it unstable in
flexion/extension.
Salter-Harris type III fracture –
avulsion of anterolateral tibial
epiphysis via anterior
tibiofibular ligament.
Ankle # classification for lateral
malleolus only.
Type A – distal to syndesmosis
Type B – at level of syndesmosis
Type C – proximal to level of
syndesmosis
Pelvis fracture classification
APC/LC fractures types I, II and
III. VS (vertical shear)
External rotation force with stress placed on anterior
tibiofibular ligament. Generally seen in adolescents as
middle and medial epiphyses fuses early. ORIF.
Scapholunate dislocation associated with signet-ring
appearance of scaphoid.
Higher the lesion → more the risk of damage to
syndesmosis with risk of instability.
Type II injuries variable instability. Type III and VS
significantly unstable.
Bladder rupture in 9-16% of all pelvic #. Extra-peritoneal
due to bone intrusion and intra-peritoneal due to
compression of distended bladder. Gross hematuria in
>95% cases.
Urethral rupture in 4-14% of all #. Meatal blood I 98%
cases.