Description

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

Distal tibia fractures that involve the articular surface or tibial plafond are also known as ‘Pilon fractures’. They usually result from axial loading of the weight-bearing surface of the tibia. The degree of comminution, soft tissue swelling, and articular incongruity indicate surgical management – which is usually external fixation followed by delayed definitive fixation if the soft tissue swelling is severe


History of the Gosselin Fracture

1855 – Gosselin first described the fracture as a note in ‘Mémoires de la Société de chirurgie de Paris‘ and ‘Gazette des hôpitaux’

1873Gosselin presented drawings and expanded further in his book Clinique chirurgicale de l’hôpital de la Charité [Vol 1; leçon 37: 608].

Messieurs,

Au n. 26 de la salle Sainte-Vierge se trouve couché, depuis une dizaine de jours, un homme de trente-cinq ans, habituellement bien portant, qui nous a été amené avec une fracture au tiers inférieur de la jambe droite, survenue à la suite d’une chute dans un escalier…

Vous avez pu sentir, en outre, le premier jour, alors qu’il n’y avait pas encore de gonflement, que cette saillie du fragment supérieur… avait sa pointe placée sur la face antéro-interne… de telle manière que la coupe du fragment supérieur présentait la forme d’un V saillant.

Deux particularités demandent ici quelques développements:

1. la forme en V du fragment supérieur

2. la difficulté de maintenir la réduction

Gosselin, 1879

Gentlemen,

In room no. 26 of the hall of the Holy Virgin there has been a man of 35 years of age lying for the past ten days; normally well kept, he was brought to us with a fracture of the distal third or the right leg, following a fall in a stairwell

One could feel, on the first day- before the swelling set in, that the superior fragment… had its edge on the anterior interior aspect… such that the shape of the fragment presented the shape of a protruding V.

Two particularities deserve attention:

1. the V shape of the superior fragment

2. the difficulty in maintaining reduction

Gosselin, 1879


Associated Persons

References

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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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