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Scientific Article   |    
Eponyms in Orthopaedics
Jeffrey L. Visotsky, MD; Leon S. Benson, MD
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In memory of a great surgeon and teacher—Hampar Kelikian (1899-1983)

Jeffrey L. Visotsky, MD
150 North River Road, Suite 100, Des Plaines, IL 60016

Leon S. Benson, MD
2401 Ravine Way, Glenview, IL 60025-5803

The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

The Journal of Bone & Joint Surgery.  2001; 83:S123-127 
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Abstract

Eponym (ep´o—nim)

[Greek eponymos, named after]

The name of a disease, structure, operation, or procedure, derived from the name of the person who discovered or described it first.

Argot (är´gõ)

[French origin "in thieves’ jargon"]

The specialized vocabulary and idioms of those in the same work.

Eponyms are commonly used in orthopaedics. Yet the individual’s name and history often remain obscure or unknown to the user. The recognition and appropriate use of the eponymic terms become more difficult as the terminology falls into disuse. It is hoped that this report will serve as a reference and a resource and will preserve orthopaedic history.

Figures in this Article
    A variety of fractures and fracture-dislocations of the talus commonly associated with aviation accidents. Anderson coined the term in 1919 after noting that fracture of the astragalus was relatively rare in civilian life but quite common in aviation accidents. The injury occurred when the rudder bar of the airplane, which was controlled by the foot, struck the instep just in front of the heel and was driven upward by the force of the airplane striking the ground at an angle. The talus absorbed most of the transmitted force and became the site of injury (Figure). The position of the foot prior to fracture is variable; it can be in acute dorsiflexion, plantar flexion, or inversion. The variety of foot positions and forces produces a variety of fractures of the talus, including compression fracture of the neck, fracture of the body of the posterior process, and fracture associated with dislocation.
    Anderson HG. The medical and surgical aspects of aviation. New York: Oxford University Press; 1919. p 183-94.
    Vertebral fracture with horizontal splitting of the spinous process and the neural arch ending with an anterior extension directed in an upward curve that usually reaches the cephalad surface of the vertebral body just in front of the neural foramen. Chance described the lesion as a rare fracture caused by a flexion injury to the spine (Figure). Most commonly an acute flexion injury to the spine results in a compression fracture of the vertebral body. If, however, for some reason the body is relatively incompressible, a disruption of the posterior elements occurs and a Chance fracture can result.
    G.Q. Chance: British surgeon.
    Chance GQ. Note on a type of flexion fracture of the spine. Br J Radiol. 1948;21:452-3.
    Reactive periosteal new-bone formation, classically seen in osteogenic sarcoma. Reactive triangle at the interface of an expanding tumor.(Figure 1, Figure 2)
    Ernest Amory Codman (1869-1940): Boston surgeon at Massachusetts General Hospital who developed clinics to study the end results of operative procedures. Codman developed a register to keep track of bone sarcomas—that is, Codman’s Register.
    Codman also wrote extensively on shoulder pathology. Another term bearing his name is Codman sign for supraspinatus tendon ruptures.
    Codman EA. The shoulder; rupture of the supraspinatus tendons in or about the subacromial bursa. Boston: privately printed; 1934.
    Fracture of the base of the first metacarpal that continues into the carpometacarpal joint and is complicated by subluxation. A triangular bone fragment from the first metacarpal is separated from its remaining portion and remains in its normal position, articulation with the trapezium. The shaft of the metacarpal is displaced proximally with its dorsal surface intact. (Figure)
    Edward Hallaren Bennett (1837-1907): Irish surgeon who began as an anatomist. He became president of the Royal College of Surgeons of Ireland.
    Bennett EH. Fractures of the metacarpal bones. Dublin J Med Sci. 1882;73:72-5.
    Also known as backfire fracture or lorry fracture. Oblique fracture of the radial styloid separating a triangular piece of bone from the radius caused by a twisting or snapping injury. Named for fractures occurring when a chauffeur was cranking an automobile and it backfired, placing extreme force on the starter handle. A direct or an indirect injury could be produced, resulting in several types of fractures. (Figure) Direct trauma was produced when the handle came out of the hand and struck the forearm, causing a fracture at the site of impact. Indirect trauma occurred when the handle kicked back, sharply forcing the hand and wrist into dorsiflexion and abduction.
    Other conditions named for Hutchinson (1828-1913) are Hutchinson’s patch (a salmon-colored area in the cornea seen in syphilitic keratitis) and Hutchinson’s teeth (a congenital condition of pegged lateral incisors and notched central incisors along the cutting edge, a sign of congenital syphilis).
    Fracture of the posterior rim of the acetabulum. The name is derived from the mechanism of injury. During an automobile accident, the passenger is thrown forward, striking the dashboard with the knee; the force is transmitted through the femur so that the femoral head is driven against the posterior rim of the acetabulum. (Figure) The position of the limb at the time of injury determines the fracture pattern.
    Osteochondral fracture of the capitellum humeri that results in a separation of a semilunar fragment of articular cartilage and the underlying bone. The fragment is usually displaced into the joint. (Figure)
    Emil Theodor Kocher (1841-1917): Swiss surgeon who won the Nobel Prize for medicine in 1909. He also devised methods of excision of the ankle joint, shoulder reduction, and excision of the tongue and designed the Kocher forceps.
    Kocher T. Chirurgische Operationslehre. Jena: Gustav Fischer; 1894.
    Fracture of the distal part of the radius within 1 in (2.5 cm) of the articular margin with dorsal displacement of the distal fragment and volar angulation accompanied by shortening. The fracture was first described by Poutreau, and Abraham Colles expanded on the description. In Colles’ original description, before the advent of x-rays, the status of the distal part of the ulna was only prominent projecting toward the palm. Colles’ description was intended to differentiate this lesion from a sprain or a dorsal dislocation of the carpus. Without the use of x-rays, the difficulty in making the diagnosis was due to the absence of crepitation because of impaction.
    Poutreau. Oeuvres posthumes 2. 1783. p 251.
    Fracture of the lateral articular surface of the distal end of the tibia. The fracture line runs vertically from the distal articular surface upward to the lateral cortex. (Figure 1, Figure 2) As described by Tillaux, the lesion was not an isolated fracture but the component of a more complicated fracture. Original diagrams by Tillaux demonstrate a fragment corresponding to both the anterior and the posterior tubercle.
    P. Tillaux (1834-1904): French physician.
    Tillaux P. Recherches cliniques et experimentales sur les fractures malleolaires. Rapport par Gosselin. Bull Acad Med, Paris, Ser. 1872;21:817.
    Test for a meniscal tear. With this method, the knee should be flexed completely so that the heel rests on the buttock or as near to this point as possible; the ankle is grasped with the right hand and the knee joint is controlled by the left. External rotation of the foot and tibia is a test for a medial meniscal tear, and internal rotation is a test for a lateral meniscal tear. A pop or catch is noted when the torn meniscus is caught between the femoral condyle and the tibial plateau.Figure
    Thomas Porter McMurray (1888-1949): Served as house surgeon to Sir Robert Jones and held first professorship of orthopaedics at the Royal Liverpool Children’s Hospital.
    McMurray TP. The semilunar cartilagesBr J Surg1942;28:407-14.
    Fracture of the lateral tubercle of the posterior process of the talus. Shepherd noted that the fracture caused no deformity and only vague symptoms. The lateral tubercle of the posterior process may form a separate ossicle and, when fusion of this ossicle to the talus occurs, it produces a prominent ridge. The prominence is susceptible to injury, and a fracture through this region may occur and be considered a Shepherd fracture. (Figure 1, Figure 2)
    Shepherd FJ. A hitherto undescribed fracture of the astragalus. J Anat Physiol. 1882;17:79-81.
    Clinical sign of ulnar nerve palsy; the little finger is abducted. It is caused by weakness in the ulnar innervated intrinsic muscle. (Figure) Wartenberg also described a syndrome of nocturnal arm dysesthesia, transient paralysis, anesthesia, and pain in the upper limb occurring along the distribution of the ulnar nerve.
    Robert Wartenberg (1887-1959): German-born American neurologist.
    Wartenberg R. The examination of reflexes, a simplification. Chicago: Year Book Publishers; 1945.
     
    Anchor for JumpAnchor for Jump
    +Aviator\|[rsquo ]\|s Astragalus:Reprinted, with permission, from: Kelikian H, Kelikian A. Disorders of the ankle. Philadelphia: WB Saunders; 1984.
     
    Anchor for JumpAnchor for Jump
    +Chance Fracture:Reprinted from: Chance GQ. Note on a type of flexion fracture of the spine. Br J Radiol. 1948;21:452.
     
     
    Anchor for JumpAnchor for Jump
    +Codman Triangle:Reprinted from: Codman EA. The shoulder; rupture of the supraspinatus tendons in or about the subacromial bursa. Boston: privately printed; 1934.
     
     
     
    Anchor for JumpAnchor for Jump
    +Edward Hallaren Bennett (1837-1907):Reprinted, with permission, from: Rang M. The story of orthopaedics. Philadelphia: WB Saunders; 2000. p 406, 407.
     
    Anchor for JumpAnchor for Jump
    +Chauffer\|[rsquo ]\|s or Hutchinson Fracture:
     
     
     
    Anchor for JumpAnchor for Jump
    +Emil Theodor Kocher (1841-1917):Reprinted, with permission, from: Rang M. The story of orthopaedics. Philadelphia: WB Saunders; 2000. p 398.
     
    Anchor for JumpAnchor for Jump
    +Abraham Colles (1773-1843): Irish surgeon who was president of the Royal College of Surgeons of Ireland. He also described Colles perineal fascia and Colles law.
     
    Anchor for JumpAnchor for Jump
    +Poutreau:Reprinted, with permission, from: Rang M. The story of orthopaedics. Philadelphia: WB Saunders; 2000. p 404.
     
    Anchor for JumpAnchor for Jump
    +Tillaux Fracture:Reprinted, with permission, from: Kelikian H, Kelikian A. Disorders of the ankle. Philadelphia: WB Saunders; 1984. p 123.
     
     
     
    Anchor for JumpAnchor for Jump
    +Thomas Porter McMurray (1888-1949):Reprinted, with permission, from: Rang M. The story of orthopaedics. Philadelphia: WB Saunders; 2000. p 54.
     
    Anchor for JumpAnchor for Jump
    +Shepard Fracture:Reprinted, with permission, from: Kelikian H, Kelikian A. Disorders of the ankle. Philadelphia: WB Saunders; 1984. p 120.
     
     
    Anchor for JumpAnchor for Jump
    +Wartenberg Sign\|[sol ]\|Wartenberg Syndrome:

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    Topics

    Anchor for JumpAnchor for Jump
    +Aviator\|[rsquo ]\|s Astragalus:Reprinted, with permission, from: Kelikian H, Kelikian A. Disorders of the ankle. Philadelphia: WB Saunders; 1984.
    Anchor for JumpAnchor for Jump
    +Chance Fracture:Reprinted from: Chance GQ. Note on a type of flexion fracture of the spine. Br J Radiol. 1948;21:452.
    Anchor for JumpAnchor for Jump
    +Codman Triangle:Reprinted from: Codman EA. The shoulder; rupture of the supraspinatus tendons in or about the subacromial bursa. Boston: privately printed; 1934.
    Anchor for JumpAnchor for Jump
    +Edward Hallaren Bennett (1837-1907):Reprinted, with permission, from: Rang M. The story of orthopaedics. Philadelphia: WB Saunders; 2000. p 406, 407.
    Anchor for JumpAnchor for Jump
    +Chauffer\|[rsquo ]\|s or Hutchinson Fracture:
    Anchor for JumpAnchor for Jump
    +Emil Theodor Kocher (1841-1917):Reprinted, with permission, from: Rang M. The story of orthopaedics. Philadelphia: WB Saunders; 2000. p 398.
    Anchor for JumpAnchor for Jump
    +Abraham Colles (1773-1843): Irish surgeon who was president of the Royal College of Surgeons of Ireland. He also described Colles perineal fascia and Colles law.
    Anchor for JumpAnchor for Jump
    +Poutreau:Reprinted, with permission, from: Rang M. The story of orthopaedics. Philadelphia: WB Saunders; 2000. p 404.
    Anchor for JumpAnchor for Jump
    +Tillaux Fracture:Reprinted, with permission, from: Kelikian H, Kelikian A. Disorders of the ankle. Philadelphia: WB Saunders; 1984. p 123.
    Anchor for JumpAnchor for Jump
    +Thomas Porter McMurray (1888-1949):Reprinted, with permission, from: Rang M. The story of orthopaedics. Philadelphia: WB Saunders; 2000. p 54.
    Anchor for JumpAnchor for Jump
    +Shepard Fracture:Reprinted, with permission, from: Kelikian H, Kelikian A. Disorders of the ankle. Philadelphia: WB Saunders; 1984. p 120.
    Anchor for JumpAnchor for Jump
    +Wartenberg Sign\|[sol ]\|Wartenberg Syndrome:
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    Leon S. Benson, M.D.
    Posted on June 27, 2008
    Dr. Benson responds to Dr. Garg
    Illinois Bone & Joint Institute, 2401 Ravine Way, Suite 200, Glenview, IL 60025

    I appreciate your review of our article and agree with your comments. Warternberg's syndrome involves entrapment of the superfical radial sensory nerve and consequently would produce dysesthesias in the radial sensory distribution, not the ulnar. Thank you for pointing out this error.

    Bhavuk Garg
    Posted on June 06, 2008
    Wartenberg syndrome
    All India Institute of Medical Science, New Delhi, INDIA

    To The Editor:

    We read with great interest the article entitled "Eponyms in Orthopaedics"(1). It greatly covers the various eponyms in orthopaedics. We just want to bring your attention that, in this article, wartenberg syndrome has been mentioned as dysthesias in ulnar nerve distribution, but the wartenberg syndrome name has been given to entrapment neuropathy of superficial radial nerve. So this needs correction.

    The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, division, center, clinical practice, or other charitable or nonprofit organization with which the authors, or a member of their immediate families, are affiliated or associated.

    Reference:

    1. Visotsky JL, Benson LS. Eponyms in orthopaedics. J Bone Joint Surg Am. 2001;83:123-127.

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