Cotton fracture

Description

Cotton fracture is a fracture of the ankle involving the lateral malleolus, medial malleolus and distal posterior aspect of the tibia (posterior malleolus). [aka *trimalleolar fracture ]

History of the Cotton fracture

1910 – Frederic Jay Cotton (1869 – 1939) in his textbook chapter on ‘Injuries at and about the ankle‘, outlines the mechanism and reduction of Pott fracture with posterior luxation and fracture

1915 – Cotton described 53 cases of bimalleolar fracture with posterior luxation and fracture of the distal posterior tibia; mechanism of causation; reduction and operative treatment. [JAMA. 1915;64:318–321.]

I have been talking about the lesion for years, until some of my house-officers at the City Hospital, wearied by long insistence, have come to refer to it as “Cotton’s fracture.”

The characteristic point of the fracture under consideration is backward dislocation with the splitting away fo a wedge large or small from the back surface of the tibia at the joint – a wedge that is displaced backward with backward dislocation of the foot. This wedge carries the posterior tibio-astragaloid ligaments; foot and tibial fragment move together, up and backward…the posterior tibial fragment is separate, though associated with fracture of both malleoli.

Cotton 1915

Associated Persons

• Frederic Jay Cotton (1869 – 1939)
• Percivall Pott (1714 – 1788)

Alternative names

• Trimalleolar fracture
• Pott fracture with backward dislocation of the lower fragment

References

• Cotton FJ. Dislocations and Joint-Fractures. W.B. Saunders. 1910
• Cotton FJ. A new type of ankle fracture. JAMA. 1915;64:318–321.
• Eponymythology: Eponymous ankle and talus injuries. LITFL