Mechanism of

Fracture Named after Description Reference

injury

when pilots in
World War I
would crash
their planes,
their foot would
Aviator often be driven
astragalus is up into the High energy
an antiquated floorboards, injury to the
reference to a leading to a hindfoot
Aviators
pattern of talar neck Various Internet sources
fracture
isolated fracture Forced
fracture/disloc dorsiflexion
ation injury of compression with axial load
the talus fractures of the
talar neck,
fractures of the
body, posterior
process or
fracture-dislocation
injuries.

fracture of
external
anterior glenoid Anterior Dislocation of the
Bankart's rotation and
Arthur Bankart associated with Shoulder at
fracture abduction of
anterior shoulder LearningRadiology.com
shoulder
dislocation

distal
radius fracture
involving the
fall on
Barton's John Rhea articular surface Barton's fracture at Who
outstretched
fracture Barton with dislocation Named It?
hand
of
the radiocarpal
joint

axial load
intra-articular
Edward along
Bennett's fracture of base Bennett's fracture at Who
Hallaran metacarpal in
fracture of Thumb Named It?
Bennett a partially
metacarpal
flexed thumb

Bosworth David M. fracture of distal severe "Bosworth fracture

fracture Bosworth fibula with external dislocation". Medcyclopae
posterior rotation of the dia. GE.
dislocation of the

1
 proximal fibula
foot
behind the tibia

fracture at the Boxer's fracture at

Boxer's punching solid
Boxers neck of the fifth Wheeless' Textbook of
fracture object
metacarpal Orthopaedics online

forced valgus
compression of knee when Bumper
Bumper
Car bumper fracture of lateral struck from fracture at TheFreeDiction
fracture
tibial plateau side by car ary.com
bumper

hyperflexion of
spine, seen
George horizontal in car Chance fracture at
Chance
Quentin fracture of accidents whe Wheeless' Textbook of
fracture
Chance vertebral body n lap Orthopaedics online
belts were
used

forced ulnar
intra-articular deviation of the Chauffeur's fracture at
Chauffeur'
Chauffeurs fracture of radial wrist causing Wheeless' Textbook of
s fracture[1]
styloid avulsion of the Orthopaedics online
radial styloid

foot dislocation
through
talonavicular and
calcaneocuboid
joints with
Chopart's Chopart's fracture
François associated
fracture- dislocation at Who Named
Chopart fractures, usually
dislocation It?
after ankle
twisting.treated
in a non weight
bearing cast for
6–8 weeks

Clay spinous process forced "Clay shovellers

shoveller's Clay shovellers fracture hyperflexion of fracture". Medcyclopaedia. 
fracture of C6, C7 or T1 neck GE.

Colles' Abraham distal fall on Colles' fracture at Who

fracture Colles radius fracture outstretched

2
 with dorsal
angulation,
hand Named It?
impaction and
radial drift

Joseph "Duverney
Duverney isolated fracture
Guichard direct trauma fracture". Medcyclopaedia. 
fracture of the iliac wing
Duverney GE.

comminuted radi
al head fracture
with
Essex- Essex Lopresti fracture at
Peter Essex- interosseous
Lopresti fall from height Wheeless' Textbook of
Lopresti membrane
fracture Orthopaedics online
disruption and
distal radioulnar
joint subluxation

radius shaft
fracture with
Galeazzi Ricardo blow to Galeazzi
dislocation of
fracture Galeazzi forearm fracture at eMedicine
distal radioulnar
joint

V-shaped distal
Gosselin's
Gosselin Leon Athanese tibia fracture
fracture at TheFreeDiction
fracture Gosselin extending into
ary.com
the tibial plafond

distraction and Hangman's fracture at

Hangman' fracture of both
Hangman extension of Wheeless' Textbook of
s fracture pedicles of C2
neck Orthopaedics online

impacted
posterior
Harold Arthur
humeral head Hill Sachs Lesion at
Hill–Sachs Hill
fracture Wheeless' Textbook of
fracture Maurice David
occurring during Orthopaedics online
Sachs
anterior shoulder
dislocation

Holstein– Arthur Holstein fracture of the Holstein-Lewis fracture at

Lewis Gwylim Lewis distal third of the Orthopedic Weblinks
fracture humerus
resulting in
entrapment of

3
 the radial nerve

unstable spinal
fracture- Thoracic Spine Fractures
Holdswort Sir Frank Wild
dislocation at the and
h fracture Holdsworth
thoracolumbar Dislocations at eMedicine
junction

Ronald McRae, Maxx

olecranon fractur Esser. Practical Fracture
Hume e with anterior Treatment 5th edition,
A.C. Hume
fracture dislocation page 187. Elsevier Health
of radial head Sciences, 2008. ISBN 978-
0-443-06876-8.

Jefferson Sir Geoffrey fracture of first compression of Jefferson fracture at Who

fracture Jefferson cervical vertebra neck Named It?

fracture of base
of 5th metatarsal Jones fracture at
Jones Sir Robert inversion of
extending into Wheeless' Textbook of
fracture Jones ankle
intermetatarsal Orthopaedics online
joint

LeFort I at Who Named It?

Le Fort series of facial direct trauma LeFort II at Who Named It?
René Le Fort
fractures fractures to face LeFort III at Who Named
It?

vertical fracture
of
Le Fort's
Léon Clément distal fibula with LeFort's fracture of the
fracture of
Le Fort avulsion ankle at Who Named It?
the ankle
of medial
malleolus

forced plantar
Jacques fracture flexion of foot
Lisfranc Lisfranc fracture at Who
Lisfranc de St. dislocation of or dropping
fracture Named It?
Martin midfoot heavy weight
on foot

Maisonne Jules Germain spiral fracture of external Maisonneuve fracture at

uve François rotation of Wheeless' Textbook of

4
fracture Maisonneuve proximal fibula ankle Orthopaedics online

vertical pelvic
fracture through
both pubic rami high energy
Joseph- Malgaigne's
Malgaigne and impact to
François fracture at TheFreeDiction
's fracture the ilium or sacro pelvis (front to
Malgaigne ary.com
iliac joint with back)
vertical
displacement

stress fracture of heavy or

March Metatarsal Stress
Marching a metatarsal unaccustomed
fracture Fracture at eMedicine
shaft exercise

proximal ulna fra
Giovanni
Monteggia cture with blow to Monteggia fracture at Who
Battista
fracture dislocation forearm Named It?
Monteggia
of radial head

distal
radius fracture
with ulnar disloca
Moore's
Moore's Edward Mott tion and
fracture at TheFreeDiction
fracture Moore entrapment of
ary.com
styloid process
under annular
ligament

posterior
dislocation of hip
impact to the
with avulsion Type II-V: Posterior
Pipkin knee with the
fracture of Fracture Dislocations at
fracture- G. Pipkin hip flexed
fragment of Wheeless' Textbook of
dislocation (dashboard
femoral head by Orthopaedics online
injury)
the ligamentum
teres

bimalleolar
Pott's eversion of Pott's fracture at Who
Percival Pott fracture of the
fracture[2] ankle Named It?
ankle

Rolando Silvio Rolando intra articular axial load Rolando's fracture at

fracture comminuted along the Wheeless' Textbook of
fracture of base metacarpal Orthopaedics online
of first causing

5
 splitting of the
proximal
metacarpal
articular
surface

Google books result Marko

Pećina, Ivan
stress fracture of
Bojanić. Overuse injuries
distal fibula 3–8 
Runner's repeated axial of the Musculoskeletal
Running cm above
fracture stress on fibula System, page 331. Informa
the lateral
Health Care,
malleolus
2004. ISBN 978-0-8493-
1428-5.

Salter– fractures
R.B. Salter, Salter–Harris
Harris involving various
W.R. Harris[3] fractures at Medscape
fracture a growth plate

lateral tibial
plateau avulsion internal
Segond Segond fracture at Who
Paul Segond fracture with rotation of the
fracture Named It?
anterior cruciate knee
ligament tear

fracture of the
lateral tubercle Shepherd's fracture at
Shepherd' Francis J.
of the posterior Mondofacto online medical
s fracture Shepherd
process of the dictionary
talus

fall on
distal
outstretched
Smith's Robert William radius fracture Smith's fracture at Who
hand with wrist
fracture Smith with volar Named It?
in flexed
displacement
position

avulsion fracture
of the medial
femoral condyle Stieda's
Stieda
Alfred Stieda at the origin of fracture at TheFreeDiction
fracture
the medial ary.com
collateral
ligament

Tillaux Paul Jules Salter–Harris forced lateral Tillaux fracture at Who

fracture Tillaux III fracture of

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 the tibia rotation of foot Named It?

undisplaced
The toddler's fracture
spiral fracture of low-energy
Toddler's revisited at Wheeless'
Toddlers distal tibia in trauma, often
fracture Textbook of Orthopaedics
children under 8 rotational
online
years old

NOTEABLES
 Talar neck is the most frequently injured site and the talus is the second most injured bone in the
foot (calcaneus is first). Proximal avascular necrosis is a potential complication of neck fractures. 

type Description AVN risk

Hawkins I Nondisplaced 0-13%
Hawkins II      Subtalar dislocation 20-50%
Hawkins III Subtalar and tibiotalar dislocation 20-100%
Subtalar, tibiotalar, and talonavicular
Hawkins IV dislocation 70-100%

Lisfranc joint complex

 Lisfranc joint complex consists of three articulations including
 tarsometatarsal articulation
 intermetatarsal articulation
 intertarsal or intercuneiform articulations
 columns of the midfoot
 medial column
 includes first tarsometatarsal joint
 middle column
 includes second and third tarsometatarsal joints
 lateral column
 includes fourth and fifth tarsometatarsal joints (most mobile)
o Ligaments
 Lisfranc ligament  
 an interosseous ligament that goes from medial cuneiform to base of 2nd metatarsal
on plantar surface        
 critical to stabilizing the 1st and 2nd tarsometatarsal joints and maintenance of the
midfoot arch
 Lisfranc ligament tightens with pronation and abduction of forefoot
 plantar tarsometatarsal ligaments
 injury of the plantar ligament between the medial cuneiform and the second and third
metatarsals along with the Lisfranc ligament is necessary to give transverse
instability.   
 dorsal tarsometatarsal ligaments

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 dorsal ligaments are weaker and therefore bony displacement with injury is often
dorsal
 intermetatarsal ligaments
 between second-fifth metatarsal bases
 no direct ligamentous attachment between first and second metatarsal
o Biomechanics
 Lisfranc joint complex is inherently stable with little motion due to
 stable osseous architecture
 second metatarsal fits in mortise created by medial cuneiform and recessed middle
cuneiform, "keystone configuration"
 ligamentous restraints
 see individual ligaments above

Classification

 Hardcastle & Myerson Classification

Type A
Complete homolateral dislocation
Type B1
Partial injury, medial column dislocation
Type B2
Partial injury, lateral column dislocation
Type C1
Partial injury, divergent dislocation
Type C2
Complete injury, divergent dislocation

 Lauge-Hansen    
o based on combination of foot position and direction of force applied at the time of
injury
o has been shown to predict the observed (via MRI) ligamentous injury in less than
50% of operatively treated fractures


o Lauge-Hansen Classification
1. Talofibular sprain or distal fibular avulsion
Supination - Adduction (SAD)   2. Vertical medial malleolus and impaction of anteromedial distal tibia
1. Anterior tibiofibular ligament sprain
2. Lateral short oblique fibula fracture (anteroinferior to posterosuperior)
Supination - External Rotation 3. Posterior tibiofibular ligament rupture or avulsion of posterior malleolus
(SER) 4. Medial malleolus transverse fracture or disruption of deltoid ligament
1. Medial malleolus transverse fracture or disruption of deltoid ligament
2. Anterior tibiofibular ligament sprain
Pronation - Abduction (PAB)        3. Transverse comminuted fracture of the fibula above the level of the syndesmosis
Pronation - External Rotation 1. Medial malleolus transverse fracture or disruption of deltoid ligament
(PER)      2. Anterior tibiofibular ligament disruption
3. Lateral short oblique or spiral fracture of fibula

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 (anterosuperior to posteroinferior) above the level of the joint
4. Posterior tibiofibular ligament rupture or avulsion of posterior malleolus

 Danis-Weber (location of fibular fracture)

o A - infrasyndesmotic (generally not associated with ankle instability)
o B - transsyndesmotic
o C – suprasyndesmotic

 AO / OTA
o 44A - infrasyndesmotic
o 44B - transsyndesmotic
o 44C - suprasyndesmotic


o

 Salter-Harris Classification
Type I 15% Fracture extends through the physis
Type II 45% Fracture extends through the physis and exits through the metaphysis, forming

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 a Thurston-Holland fragment
Fracture extends through the physis and exits through the epiphysis
Seen with medial malleolus fractures and Tillaux fractures
Type III 25% Increased risk of physeal arrest
Fracture involves the physis, metaphysis and epiphysis
Can occur with lateral malleolus fractures, usually SH I or II
Seen with medial malleolus shearing injuries and triplane fractures
Type IV 25% Increased risk of physeal arrest
Crush injury to the physis
Can be difficult to identify on initial presentation (diagnosis is usually made when growth
arrest is seen on follow-up radiographs)
Type V 1% Increased risk of physeal arrest
Perichondral ring injury
Type VI rare Results from open injury (i.e. lawnmower) or iatrogenic during surgical dissection

o Mechanism of injury

 Dias & Tachdjian Classification

 (patterned off adult Lauge-Hansen classification)
Grade 1
Adduction or inversion force avulses the distal fibular epiphysis (SH I or II)
Occasionally can be transepiphyseal
Rarely occurs with failure of lateral ligaments
Grade 2
Supination- Further inversion leads to distal tibial fracture (usually SH III or IV, but can be SH I or II)
inversion Occasionally can cause fracture through medial malleolus below the physis
Plantarflexion force displaces the tibial epiphysis posteriorly (SH I or II)
Thurston-Holland fragment is composed of the posterior tibial metaphysis
and displaces posteriorly
Supination- Occurs without fibular fracture
plantarflexion Can be difficult to see on AP radiograph
Grade 1
External rotation force leads to distal tibial fracture (SH II)
Distal fragment displaces posteriorly
Thurston-Holland fragment displaces posteromedially
Easily visible on AP radiograph (fracture line extends proximally and medially)
Grade 2
Supination-external Further external rotation leads to low spiral fracture of fibula
rotation (anteroinferior to posterosuperior)
External rotation force leads to distal tibial fracture (SH I or II) and transverse fibula fracture
Occasionally can be transepiphyseal medial malleolus fracture (SH II)
Distal tibial fragment displaces laterally
Pronation/eversion- Thurston-Holland fragment is lateral or posterolateral distal tibal metaphysis
external rotation Can be associated with diastasis of ankle joint
Leads to SH V injury of distal tibial physis
Can be difficult to identify on initial presentation (diagnosis
typically made when growth arrest is seen
Axial compression on follow-up radiographs)

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