Learning objectives
There are a subset of fractures that are almost exclusively limited to a specific occupational activity, to the extent that they are named after them. Some of the occupations that give their name to certain fracture patterns may not be practiced anymore, and are therefore very rarely seen in their original context. Clinicians may therefore struggle to realise the historical association behind the name given to a fracture type.
With this background in mind, the objectives of this article include the following:
To cultivate an...
Background
The following six fracture patterns were selected for review:
Aviator’s astragalus
Chauffeur fracture
Clay shoveler fracture
Gamekeeper’s thumb
March fracture
Paratrooper fracture
All selected fractures are named after occupational activities that are not commonly practiced today, and were therefore considered of appropriate historical significance to be included for review.
The historical context, mechanism of injury and imaging characteristics of each fracture pattern are explored. An effort was additionally made to describe how such injuries typically occur in the modern era.
Imaging findings OR Procedure details
Aviator's astragalus
[Fig 1]
Definition
Isolated fracture of the neck of the talus (astragalus) 1
Mechanism of injury
Forced dorsiflexion of the ankle joint with high-energy axial load, resulting in impaction of the talar neck against the anterior tibia 1
Historical context
In 1919, H. Graeme Anderson, a British surgeon who had consulted for the Royal Flying Corps during the Great War, published a case series of talar injuries sustained by downed fighter pilots 2.
When bracing for impact, the sole of the pilot’s foot...
Conclusion
This article explores six fractures types that are still referred to by the manner in which they were originally sustained, in certain occupational activities that are not commonly practiced today.
Gaining an appreciation of the historical context of the injury is useful to understand the name behind these fractures.
Personal information
Z. Vajuhudeen:
Nothing to disclose
References
Summers NJ, Murdoch MM. Fractures of the talus: a comprehensive review. Clinics in podiatric medicine and surgery. 2012 Apr;29(2):187-203.
Anderson HG. The medical and surgical aspects of aviation. H. Frowde, Hodder & Stoughton; 1919.
Coltart WD. Aviator's astragalus. The Journal of Bone and Joint Surgery. British volume. 1952 Nov;34(4):545-66.
Agrawal A. Musculoskeletal etymology: What’s in a name?. Journal of clinical orthopaedics and trauma. 2019 Mar 1;10(2):387-94.
Peterson L, Goldie IF, Irstam L. Fracture of the neck of the talus: a clinical study. Acta Orthopaedica Scandinavica....