Description

Duverney fracture – isolated fracture of the iliac wing due to direct lateral compression fracture of the iliac wing. Most commonly occurring in the setting of a direct blow to the ilium. Stable pelvic injury but may require operative intervention in cases of severe comminution.

Duverney fracture left ilium pelvis LITFL 1000
Left Duverney fracture

The eponymous terms of Duverney fracture and Malgaigne fracture are now falling into disuse. Both fracture types were identified before radiographic interpretation was available. The imaging techniques and pelvic injury classification systems have meant the eponymous terms are less relevant today.


History of the Duverney fracture

1751 – Duverney’s description of the isolated fracture of the wing of the ilium is found in his Traité des maladies des os pub­lished from his notes, 21 years after his death. The two volume work contains sec­tions on the diagnosis and treatment of frac­tures; dislocations; and diseases of bone.

On the fracture of the wing of the ilium:

“Un Ouvrier portoit un bandage d’acier. Il tomba sur le côté de fort haut. Le bandage fut cassé. Il ne se trouva presque point incommodé dans le moment, si ce n’est qu’il ne pût marcher. Il fut porté à l’Hôtel dieu, où l’on, ne connut aucune fracture dans l’etendue de son corps.

Il fut enveloppé dans les peaux de moutons, dont il ne reçut que peu de soulagement ; les urines se supprimerent; il se déclara une grande constitution , avec une ecchymose qui occupoit tout le côté sur lequel il eioit tombé; la jambe & la cuisse etoient sans mouvement. 

Le gonflement & la tension de ces parties firent penser que la cuisse etoit luxée; accident dont l’on ne pût s’assurer, non plus que de la fracture de l’os des iles. Le malade fut soigneusement traité ; mais ces soins par la suite devînrent inutiles ; il mourut le quatorzième de sa chûte. Je me trouvai à l’ouvertuœ du cadavre. 

Le bassin etoit entièrement plein de pus; l’iliaque & le psoas, tout déchirés, & l’os des iles fracturé en travers , sans que les pièces eussent changé de place.”

Duverney J.G, 1751

“A worker was carrying a steel rim. He fell onto his side from a great height. The rim broke. He did not feel hardly uncomfortable in the moment, were it not that he could not walk. He was taken to the Hôtel-dieu, where we did not recognize a fracture in the whole length of his body.

He was wrapped in lambskins, from which he gained little relief. His urination ceased; a great consitution presented, with an ecchymosis occupying the whole side onto which he fell; the leg and the thigh were without movement.

The swelling and the tension of these parts suggested that the thigh was luxated; an accident of which we could not be certain, no more than of a fracture of the iliac bone. The patient was treated carefully; but subsequently these treatments became useless; he died on the fourteenth following his fall. I was present at the opening of the cadaver. 

The pelvis was entirely filled with pus; the iliacus and the psoas completely torn, and the Iliac bone fractured in transverse, without the fragments having moved.” 

Duverney J.G, 1751


Associated Persons

References

Historical references

Eponymous term review


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Resident medical officer in emergency medicine MB ChB (Uni. Dundee)  MRCS Ed. Avid traveller, yoga teacher, polylinguist with a passion for discovering cultures.

Emergency physician MA (Oxon) MBChB (Edin) FACEM FFSEM with a passion for rugby; medical history; medical education; and asynchronous learning #FOAMed evangelist. Co-founder and CTO of Life in the Fast lane | Eponyms | Books | Twitter |

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