33 Eponyms of Fractures

CLINICAL IMAGAGINGAN ATLAS OF DIFFERENTIAL DAIGNOSIS

EISENBERG

DR. Muhammad Bin Zulfiqar PGR-FCPS III SIMS/SHL

• Fig B 33-1 Mallet (baseball) finger. The small triangular fragment (arrow) is proximally retracted by the action of the common extensor tendon. The flexion deformity results from the unopposed action of the flexor digiti profundus tendon.

• Fig B 33-2 Bennett fracture.

• Fig B 33-3 Rolando fracture. In addition to the fracture of the ulnar margin, similar to that found in a Bennett fracture, there is a second fragment at the radial margin, which characterizes this as a Rolando fracture.39

• Fig B 33-4 Gamekeeper thumb with fracture.39

• Fig B 33-5 Boxer fracture (arrow).

• Fig B 33-6 Colles' fracture. (A) Frontal and (B) lateral projections show overriding and dorsal displacement of the distal fragment.

• Fig B 33-7 Smith fracture. Lateral view shows volar angulation of the distal fragment, the reverse of that encountered in a Colles fracture.39

• Fig B 33-8 Chauffeur fracture. Complete fracture extending diagonally across the base of the radial styloid.39

• Fig B 33-9 Reverse Barton fracture. (A) Fracture of the distal radius with shortening of the radius and avulsion of the ulnar styloid. The appearance is similar to a Colles or a Smith fracture in this projection. (B) Lateral projection shows that the fracture of the distal radius creates a large fragment from the anterior rim of the distal radius. The posterior rim is intact. The anterior fragment includes approximately two-thirds of the joint surface.39

• Fig B 33-10 Nightstick fracture. Minimally displaced oblique fracture of the ulna without associated fracture of the radius. (L, left.)39

• Fig B 33-11 Monteggia fracture. Displaced fracture of the ulnar shaft associated with anterior dislocation of the radial head.

• Fig B 33-12 Galeazzi fracture. A lateral projection shows the dorsally angulated distal radial fracture and the obvious disruption of the distal radioulnar joint. The ulna is intact.39

• Fig B 33-13 Greenstick fracture. Frontal image of a young child who fell off a bike shows incomplete fractures of the radius and ulna. The cortex is fully broken (black arrows) on one side of the bone and intact on the other side (white arrows).40

• Fig B 33-14 Little League elbow. Frontal and lateral views of the elbow in an active pitcher shows rarefaction and fragmentation of the capitellum (arrow) from repetitive overuse of the elbow.40

• Fig B 33-15 Hill-Sachs deformity.

• Fig B 33-16 Bankhart fracture. Fracture of the anterior rim of the glenoid (arrow) as a result of anterior dislocation of the shoulder.39

• Fig B 33-17 March fracture. Frontal radiographs of the right foot of a college gymnast show the early (A) and late (B) findings of a fatigue fracture of the second metatarsal (arrow). The fracture completely healed with rest.40

• Fig B 33-18 Jones' fracture. Note that the fracture line is transverse (black arrow), whereas the normal apophysis in this child has a vertical orientation (white arrow).

• Fig B 33-19 Lisfranc injury. Gross lateral displacement of the second through fifth metatarsals.

• Fig B 33-20 Chopart dislocation. (A) Lateral and (B) frontal views. Lateral projection shows complete disruption of the calcaneocuboid joint. The cuboid bone is displaced plantarward, while the talonavicular joint is subluxed.39

• Fig B 33-21 Toddler fracture. Frontal radiograph of a young ambulatory infant, who fell and twisted his right lower leg, shows a spiral fracture (arrows) in the distal portion of the tibia.40

• Fig B 33-22 Maisonneuve fracture. (A) Frontal and (B) lateral views of the ankle demonstrate an oblique fracture of the medial malleolus and a fracture of the posterior tibial tubercle (arrows). (C) A view of the proximal leg reveals the associated spiral fracture of the proximal shaft of the fibula (arrow).41

• Fig B 33-23 Jefferson fracture. (A) On a frontal tomogram, there is lateral displacement of the lateral masses of C1 bilaterally (white lines). (B) A CT scan in another patient shows the unilateral break in the arch of C1 (arrow). (D, dens.)

• Fig B 33-24 Hangman fracture. Bilateral fracture of the neural arch of C2 (broad arrow). The abnormal air within the soft tissues (thin arrows) was due to an associated fracture of the larynx.

• Fig B 33-25 Clay shoveler fracture. (A) Frontal view of the cervical spine shows the characteristic double-spinous-process sign resulting from the caudad displacement of the avulsed fragment (open arrow) with respect to the normal position of the major portion of the spinous process (closed arrow). (B) A lateral view clearly shows the avulsed fragment (arrow).

• Fig B 33-26 Chance fracture. (A) A frontal view shows the characteristic empty appearance of the involved vertebral body due to fractures of the posterior elements. Note the fractures of the left pedicle (black arrow) and transverse process (white arrows). (B) CT scan in another patient shows a fracture of the lumbar vertebral body (black arrows) associated with a lamina fracture at the same level (white arrow).

• Fig B 33-27 Malgaigne fracture. There are fractures of the right superior and inferior pubic rami (white arrows) and wide separation of the ipsilateral sacroiliac joint (large black arrows). There is also some sacroiliac joint separation, an avulsion of the L5 transverse process on the left, and a fracture of the right pubic symphysis (small black arrow).

• Fig B 33-28 Straddle fracture. Bilateral fractures (arrows) of the superior and inferior pubic rami.

• Fig B 33-29 LeFort planes of weakness. (A) Frontal view corresponding to a Caldwell projection. (B) Lateral view.42