fbpx

Eponymous ankle and talus injuries

Eponymythology: The myths behind the history

Eponymythology associated with signs, symptoms, investigation and management of ankle and talus injuries, fractures and conditions. We review related eponyms, the person behind their origin, their relevance today, and modern terminology


Ankle and Talus Fracture Classification

Danis-Weber classification (1949, 1972)
Danis Weber A B C ankle fracture 150 2

The Danis-Weber classification (more commonly – the Weber classification) is a simple method of describing ankle fractures.

It has three categories (Type A, B and C.) based primarily upon the fracture of the fibula. The higher (more proximal) the fibular fracture, the greater the likelihood for ankle mortise insufficiency. first described by Robert Danis in 1949 and later modified and popularised by Bernhard Georg Weber in 1972, 10 years after Danis’ death.


Lauge-Hansen classification of ankle injury (1950)

The Lauge-Hansen classification of ankle injuries was developed on the basis of predictable fracture patterns defined by injury mechanism and resultant radiological findings in 1950.

The Lauge-Hansen classification requires three radiographic views of the ankle (anteroposterior, mortise and lateral) and is characterised with specific two-word descriptors of the injury mechanism: The First word: describes the position of the foot at the time of injury (supination or pronation) and the Second word: describes the deforming force direction (abduction, adduction, or external rotation)


Hawkins classification (1970)
Hawkins classification talus 150

Hawkins classification: Classification system for talar neck fractures. Classification system for vertical neck fractures of the talus, the commonest type of talus fracture. High energy injury usually associated with forced dorsiflexion and axial load. Associated with risk of avascular necrosis (AVN)

Hawkins originally described Types I-III in 1970 with Canale and Kelly adding Type IV in 1978


Eponymous Ankle Fractures

Bosworth fracture (1947)
Bosworth-Fracture-2

Bosworth fracture-dislocation is an archaic eponym for rare ankle injury in which the proximal fibular fragment is entrapped (fixed displacement) behind the tibia, frequently irreducible by closed methods. Archaic term for ankle fracture-dislocation


Cotton fracture (1915)

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 ]

Cotton (1910) in his textbook chapter on ‘Injuries at and about the ankle‘, outlines the mechanism and reduction of Pott fracture with posterior luxation and fracture. In 1915 he described 53 cases of bimalleolar fracture with posterior luxation and fracture of the distal posterior tibia; mechanism of causation; reduction and operative treatment


Gosselin fracture (1855)
Gosselin fracture

Gosselin fracture is a V-shaped fracture of the distal tibia with extension into the tibial plafond, dividing it into anterior and posterior segments


Maisonneuve Fracture (1840)
Maisonneuve-Fracture 150

Maisonneuve fracture is a spiral fracture of the upper third of the fibula associated with a tear of the distal tibiofibular syndesmosis and the interosseous membrane.

There is an associated fracture of the medial malleolus or rupture of the deep deltoid ligament. Rupture of the stabilizing ligaments of the distal tibiofibular syndesmosis will result in widening of the ankle mortise on radiographs. Additional findings such as avulsion fracture of the medial or posterior malleoli, or tear of the deltoid ligaments may also be present


Pott fracture (1768)
Pott fracture (1768)

Pott fracture is an archaic eponym for fracture of the distal fibula, 2–3 inches proximal to the ankle joint.

Effectively a fracture-dislocation of the ankle, involving a fracture of the fibula, disruption of the deltoid ligaments with an intact tibiofibular ligament resulting in lateral displacement of the talus.


Tillaux-Chaput fracture (1872, 1907)
Tillaux Fracture

The Tillaux fracture is a fracture of the anterolateral tibial epiphysis commonly seen in adolescents (Salter-Harris III tibial fracture).

Tillaux first described from experiments on cadavers in 1876. Chaput was the first to demonstrate a roentgenogram of a fracture in 1907 (*Tillaux-Chaput fracture)


Wagstaffe-Le Fort Fracture (1875, 1886)
Wagstaffe-Le-Fort-Fracture 150

Wagstaffe-Le Fort Fracture is a vertical avulsion fracture of the anteromedial aspect of the distal fibula due to avulsion of the anterior tibiofibular ligament attachment (ATFL). [aka Le Fort Ankle Fracture]


Talus

Cedell fracture (1974)
Cedell-fracture-Watanabe-150

Cedell fracture is a posterior talar process fracture with injury to the posteromedial tubercle caused by forced dorsiflexion and pronation.

Fracture of the posterior process of the talus is an uncommon injury that is often missed on plain X-Ray and misdiagnosed as ankle sprain. In one case series, 17 of 20 patients with fractures were misdiagnosed as an ankle sprain.


Shepherd fracture (1882)

Sherpherd fracture is a posterior talar process fracture with injury to the lateral tubercle caused by inversion or extreme equinus. Otherwise known as fracture of the lateral tubercle of the posterior process of the talus.


Clinical Examination

Simmonds-Thompson Test (1957, 1962)
Simmonds-Thompson Test 150

Simmonds-Thompson test is a diagnostic tool for Achilles tendon rupture. The absence of foot plantarflexion on calf compression is interpreted as a positive test result and indicative of Achilles tendon rupture

Simmonds-Thompson test result should be considered positive when the physical response to calf squeezing is aberrant and the foot fails to plantarflex owing to incongruity of the Achilles tendon, indicative of rupture


References

[cite]

eponymythology

the myths behind the names

BA MA (Oxon) MBChB (Edin) FACEM FFSEM. Emergency physician, Sir Charles Gairdner Hospital.  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 |

Leave a Reply

This site uses Akismet to reduce spam. Learn how your comment data is processed.