Name the fracture(s)

It’s been awhile, so here goes:
Name the fracture(s). Your prize: the adoration of your fellow commenter. Extra points for the correct eponym of the pediatric fracture type (guess what I’m thinking, sorry).

name the fxname the fx
Click for larger images
And, yes, these are the same wrist on the same patient (sorry, no lateral available).

Update: Answers in the extended entry

Answer: displaced Salter-Harris II fracture of the distal radius with a buckle fracture of the ulnar aspect of the distal radius.

Also known as: Everybody finds the first fracture, not everyone finds the second one.

Salter Harris II fracturebuckle fracture of the ulnar aspect of the distal radius
Click for larger images

The Salter Harris classification of fractures from About.com.

Ulnar styloid fracture guesses are incorrect, as the patient wasn’t tender there, but there’s no way to know that from the film (IHMO), therefore no deduction for that answer. Barton fracture isn’t a bad answer, but is usually reserved for patients with a mature skeleton (the eponym I was looking for was Salter Harris; in retrospect, possibly not an eponymous fracture). The other fun eponymous fracture of the wrist is the Chauffeur’s.

Thanks for playing!


Comments

  1. This looks like a Barton fracture of the distal radius and a probable sprain-fracture of the distal ulna.

  2. I think it’s a styloid fracture.

  3. qvoperro says:

    salter-harris? don’t know what type.

  4. Yohanan Petrovsky-Shtern says:

    Stop posting boring medical stuff. We want to hear more about Fort Worth!

  5. I don’t know if Yohanan is chiding me for my non-medical postings, or really wants that 14 part series I’m writing about my local tourism. Hmmm.

  6. Salter-Harris. I forget what type it is when the epiphysis is completely broken, but that is what it looks like to me (type IV?).
    Reduce, Splint, Check for correct alignment by X-ray, check for intact nerves and circulation distally, and then if all is right, send them on their merry way with an outpatient follow-up with their PCP.

    So, how far off am I?

  7. There is a salter-harris type II fracture of the distal radius along with an ulnar styloid fracture. I don’t know the eponym.

  8. HA Davila says:

    I need to know the history of the patient. Is there snuffbox tenderness? Does he have full ROM?

  9. You’re driving me nuts here Grunt Doc! My medical knowlege is limited to what I’ve experienced … I haven’t had to deal with this, curiosity is about to kill the cat! I’ve been back about 10 times to see if the answer is up yet!

  10. No snuffbox tenderness; very limited ROM (won’t move it, essentially).

  11. Complete styloid fracture on right ulnar.

  12. No I am not chiding! I think Fort Worth is great place and enjoy hearing about it. I’m in the rustbelt and thinking of relocating!

  13. Jim in Texas says:

    Ft. Worth? isn’t that a suburb of Plano??

  14. Jim, Jim, Jim, what are you up to? Be nice, or I’ll sic that lawyer commenter on you.

  15. Won’t move it or can’t move it?

    How can they break a wrist and not have snuff box tenderness??? Ok, I’m not a doc, but that’s foreign to me, but then, with my lupus, I always have snuffbox tenderness so maybe my opinion doesn’t count here.

    WHAT IS IT?!?!? (you’re enjoying this aren’t you Grunt Doc?)

  16. drugseekersbeware says:

    Ulnar styloid Fx, also fx of distal radius Salter Harris III
    S- seperated
    A- above
    L- low
    T- thru
    ER- emergency impacted physis

  17. Jim in Texas says:

    It’s kind of scary to hear a wide range of diagnoses ?slap a band aid on it and throw him out!? to ?If this was a horse, I?d put him down.?

    WHATEVER GD finally deigns to tell us, I?m writing that puppy down and make DAMN sure I don?t ever get it!